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PENNSYLVANIA CVS PHARMACY, L.L.C.
CH031670 PUBLIC HEALTH MANAGEMENT CORPORATION
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Covered Entity Details
Entity Name
PUBLIC HEALTH MANAGEMENT CORPORATION
Subdivision Name
Public Health Management Corporation
Type
HRSA-Funded Health Center
340B ID
CH031670
Entity Address
Centre Square East
1500 Market Street
Philadelphia, PA 19102-2100
Grant Number
H80CS00016
Participating Start Date
7/1/2004
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02156
5843-45 RISING SUN AVENUE
PHILADELPHIA, PA 19120
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Cohen, President and CEO
(215) 985-2501
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/12/2019
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