340B Drug Pricing Program Database


PENNSYLVANIA CVS PHARMACY, L.L.C. - information as of 5/20/2025 12:54:47 AM


PENNSYLVANIA CVS PHARMACY, L.L.C.

CVS PHARMACY # 17207
4000 MONUMENT RD
PHILADELPHIA, PA 19131



  • Contracts
  • History
Contracts
Contract Detail340B IDEntity NameSub NameEntity TypeAddressAddress Cont.CityStateBegin DateTerm DateEdit Date
DetailsDSH390174THOMAS JEFFERSON UNIVERSITY HOSPITAL Disproportionate Share Hospital111 South 11th Street
PhiladelphiaPA04/01/2025 4/1/2025 12:01 AM
DetailsFQHCLA463Mazzoni CenterWashington WestHealth Center Program Look-Alike1201 Locust St.
PhiladelphiaPA10/01/2024 10/1/2024 12:01 AM
DetailsFQHCLA463AMazzoni CenterBainbridgeHealth Center Program Look-Alike1348 Bainbridge St
PhiladelphiaPA10/01/2024 10/1/2024 12:01 AM
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesPharmacy AddressUpdate PENNSYLVANIA CVS PHARMACY, L.L.C. TARGET PHARMACY # 17207 4000 MONUMENT RD PHILADELPHIA, PA 19131PENNSYLVANIA CVS PHARMACY, L.L.C. CVS PHARMACY # 17207 4000 MONUMENT RD PHILADELPHIA, PA 191316/29/2016 12:32 PM
DetailsCommentsInsert   2/5/2016 2:36 PM
DetailsIs DeletedInsert  False2/5/2016 2:36 PM
AddressesPharmacy AddressInsert  PENNSYLVANIA CVS PHARMACY, L.L.C. TARGET PHARMACY # 17207 4000 MONUMENT RD PHILADELPHIA, PA 191312/5/2016 2:36 PM
DetailsNameInsert  PENNSYLVANIA CVS PHARMACY, L.L.C.2/5/2016 2:36 PM