340B Drug Pricing Program Database

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 02719
97-01 LIBERTY AVE.
OZONE PARK, NY 11417

Pharmacy Comments

Approval Date

10/4/2019

Contract Begin Date

10/4/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/11/2023
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Ramon Rodriguez, President and CEO
(718) 963-7101

Contract Pharmacy Representative

Wyckoff Heights Medical Center
Joseph S Rumore, Director of Pharmacy
(718) 963-7547 Ext: 7141

Signed By Date

10/4/2019