340B Drug Pricing Program Database

Pharmacy Name

MARYLAND CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01522
22565 THREE NOTCH RD.
CALIFORNIA, MD 20619

Pharmacy Comments

Approval Date

9/10/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/30/2022
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Carrie J Jennison, Chief Financial Officer
(301) 475-6003

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

9/7/2018