Contract Pharmacy Details

CAREMARK TENNESSEE SPECIALTY PHARMACY, L
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.

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 TENNESSEE SPECIALTY PHARMACY, L

Pharmacy Address

DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
8370 WOLF LAKE DR
STE 107
BARTLETT, TN 38133

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

340B Drug Pricing Program Database