340B Drug Pricing Program Database
PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03122B N PENN COMPREHENSIVE HEALTH SVCS - information as of 5/28/2025 12:11:44 AM
Covered Entity Details
Entity Name
N PENN COMPREHENSIVE HEALTH SVCS
Subdivision Name
ELKLAND LAUREL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH03122B
Entity Address
103 Forestview Drive
Elkland, PA 16920-1403
Grant Number
H80CS00682
Participating Start Date
1/1/2009
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01091
430 KEYSTONE AVE
SAYRE, PA 18840
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ronald M Gilbert, CFO
(570) 828-3869
Contract Pharmacy Representative
Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118
Signed By Date
10/16/2023
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