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CVS ALBANY, L.L.C.
CH022070 ANTHONY L JORDAN HEALTH CORP
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Covered Entity Details
Entity Name
ANTHONY L JORDAN HEALTH CORP
Subdivision Name
Main Site
Type
HRSA-Funded Health Center
340B ID
CH022070
Entity Address
82 Holland St
Rochester, NY 14605-2131
Grant Number
H80CS21582
Participating Start Date
10/1/2011
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01925
1259 ROUTE 332
FARMINGTON, NY 14425
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Clune, CFO
(585) 423-2813
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/14/2019
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