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CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
Subdivision Name
WHITNEY M. YOUNG, JR. HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH020110
Entity Address
920 Lark Dr
Albany, NY 12207-1300
Grant Number
H80CS00433
Participating Start Date
10/1/1995
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
CAREMARK NEW JERSEY SPECIALTY PHCY, LLC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
180 PASSAIC AVE UNIT B-5
FAIRFIELD, NJ 07004
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David H. Shippee, President & CEO
(518) 591-4459
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2019
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