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COORDINATED CARE NETWORK PHARMACY
STD183601 Novus Adult Care Services
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Covered Entity Details
Entity Name
Novus Adult Care Services
Subdivision Name
Stroudsburg Office
Type
Sexually Transmitted Diseases
340B ID
STD183601
Entity Address
28 N 7th Street
Stroudsburg, PA 18360
Grant Number
NH25PS005144
Participating Start Date
7/1/2018
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK PHARMACY
Pharmacy Address
268 MARTIN LUTHER KING JR. BLVD.
NEWARK, NJ 07102
Pharmacy Comments
Contract Details
Approval Date
5/11/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joe Mannino, CFO
(610) 419-0502
Contract Pharmacy Representative
CCN AMERICA LP
Thomas J. Pollack, Vice President and CFO
(412) 349-6303
Signed By Date
4/16/2018
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