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CVS PHARMACY, INC.
CH01143T LYNN COMMUNITY HEALTH, INC.
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Covered Entity Details
Entity Name
LYNN COMMUNITY HEALTH, INC.
Subdivision Name
CLASSICAL HIGH SCHOOL SBHC
Type
HRSA-Funded Health Center
340B ID
CH01143T
Entity Address
235 Ocallaghan Way
Lynn, MA 01905-1599
Grant Number
H80CS00624
Participating Start Date
10/1/2012
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 01204
509 EASTERN AVENUE
LYNN, MA 01902
Pharmacy Comments
Contract Details
Approval Date
1/10/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kiame Mahaniah, Chief Executive Officer
(781) 596-2502 Ext: 2707
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2019
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