Contract Pharmacy Details

CVS ALBANY, L.L.C.
DSH330101 NEW YORK-PRESBYTERIAN HOSPITAL

Covered Entity Details

Entity Name

NEW YORK-PRESBYTERIAN HOSPITAL

Subdivision Name

UNIVERSITY HOSP OF COLUMBIA & CORNELL

Type

Disproportionate Share Hospital

340B ID

DSH330101

Entity Address

525 East 68th Street
New York, NY 10065

Medicare Provider Number

330101

Participating Start Date

4/1/2003

Last Recertification Date

8/27/2024

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00106
114 PONDFIELD ROAD
BRONXVILLE, NY 10708

Pharmacy Comments

Contract Details

Approval Date

1/7/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/15/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

William Farrell, SVP, Finance
(212) 297-4358

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/7/2020

340B Drug Pricing Program Database