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CVS PHARMACY, INC.
STD02118 Multicultural AIDS Coalition
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Covered Entity Details
Entity Name
Multicultural AIDS Coalition
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD02118
Entity Address
7 Palmer Street, 3rd Floor
Roxbury, MA 02119
Grant Number
6 NU62PS924700-01-01
Participating Start Date
4/1/2022
Last Recertification Date
5/6/2025
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
Contract Termination Date
Termination Reason
7/1/2021
Covered Entity Terminated
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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