340B Drug Pricing Program Database
PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03122S NORTH PENN COMPREHENSIVE HEAL - information as of 6/15/2025 7:02:47 AM
Covered Entity Details
Entity Name
NORTH PENN COMPREHENSIVE HEAL
Subdivision Name
Towanda Laurel Health Center
Type
HRSA-Funded Health Center
340B ID
CH03122S
Entity Address
410 Main Street UNIT 102
Towanda, PA 18848-1865
Grant Number
H80CS00682
Participating Start Date
10/1/2024
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05709
405 W DUBOIS AVE
DUBOIS, PA 15801
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
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
4/15/2025
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