Contract Pharmacy Details

RHODE ISLAND CVS PHARMACY, L.L.C.
CH011820 THUNDERMIST HEALTH CENTER

Covered Entity Details

Entity Name

THUNDERMIST HEALTH CENTER

Subdivision Name

THUNDERMIST DENTAL ADMIN WOONSOCKET

Type

HRSA-Funded Health Center

340B ID

CH011820

Entity Address

25 John A. Cummings Way
Woonsocket, RI 02895-3240

Grant Number

H80CS00454

Participating Start Date

10/1/2002

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

RHODE ISLAND CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00590
1054 CASS AVENUE
WOONSOCKET, RI 02895

Pharmacy Comments

03/19/2012 changed address (was 166 CASS AVENUE)

Contract Details

Approval Date

10/20/2011

Contract Begin Date

12/15/2007

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

MARIA MONTANARO, PRESIDENT and CEO
(401) 767-4100

Contract Pharmacy Representative

VAUGHN KINOSIAN, REGIONAL MANAGER
(401) 952-8627

Signed By Date

11/30/2007

340B Drug Pricing Program Database