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CVS PHARMACY, INC.
CH010700 BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
BROCKTON NEIGHBORHOOD HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH010700
Entity Address
63 Main St
Brockton, MA 02301
Grant Number
H80CS00560
Participating Start Date
4/1/1999
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 00861
355 CENTRE ST.
BROCKTON, MA 02302
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SUSAN G. JOSS, Senior Advisor
(508) 894-3203
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2018
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