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CVS PHARMACY, INC.
RWI02130 Multicultural AIDS Coalition
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Covered Entity Details
Entity Name
Multicultural AIDS Coalition
Subdivision Name
Type
Ryan White Part A
340B ID
RWI02130
Entity Address
7 Palmer Street, 3rd Floor
Roxbury, MA 02119
Grant Number
H89HA00011
Participating Start Date
7/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 02283
715 MORRISSEY BOULEVARD
DORCHESTER, MA 02122
Pharmacy Comments
Contract Details
Approval Date
1/4/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary K. Daffin, Executive Director
(617) 840-8604
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/4/2019
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