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CVS PHARMACY, INC.
CHC11299-00 CODMAN SQUARE HEALTH CENTER, INC
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Covered Entity Details
Entity Name
CODMAN SQUARE HEALTH CENTER, INC
Subdivision Name
Codman Square Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11299-00
Entity Address
637 Washington St.
Dorchester, MA 02124-3510
Grant Number
H80CS11299
Participating Start Date
7/1/2012
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 02283
715 MORRISSEY BOULEVARD
DORCHESTER, MA 02122
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sandra Cotterell, CEO
(617) 822-8123
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
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