Contract Pharmacy Details

CVS ALBANY, L.L.C.
RW4248550 The Albany Damien Center Inc.

Covered Entity Details

Entity Name

The Albany Damien Center Inc.

Subdivision Name

Type

Ryan White Part D

340B ID

RW4248550

Entity Address

728 Madison Ave
Suite 100
Albany, NY 12208-3302

Grant Number

H12HA24855

Participating Start Date

1/1/2020

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

CVS/PHARMACY # 16851
428 BALLTOWN RD
SCHENECTADY, NY 12304

Pharmacy Comments

Contract Details

Approval Date

1/8/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Perry Junjulas, Executive Director
(518) 449-7119 Ext: 102

Contract Pharmacy Representative

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

Signed By Date

1/8/2020

340B Drug Pricing Program Database