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CVS PHARMACY, INC.
CH01143AS Lynn Community Health, Inc.
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Covered Entity Details
Entity Name
Lynn Community Health, Inc.
Subdivision Name
Lynn Vocational Technical High School, School Based Health Center, Annex
Type
HRSA-Funded Health Center
340B ID
CH01143AS
Entity Address
90 Commercial St
Lynn, MA 01905-2906
Grant Number
H80CS00624
Participating Start Date
1/1/2020
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
10/9/2019
Contract Begin Date
1/1/2020
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
10/9/2019
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