Contract Pharmacy Details

CVS ALBANY, L.L.C.
CH02152N OPEN DOOR FAMILY MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

OPEN DOOR FAMILY MEDICAL CENTER, INC.

Subdivision Name

Open Door Mamaroneck

Type

HRSA-Funded Health Center

340B ID

CH02152N

Entity Address

689 Mamaroneck Avenue
Mamaroneck, NY 10543-1925

Grant Number

H80CS00160

Participating Start Date

7/1/2017

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 02578
16 WEYMAN AVE.
NEW ROCHELLE, NY 10805

Pharmacy Comments

Contract Details

Approval Date

1/17/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/12/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Lindsay Farrell, President and CEO
(914) 502-1450

Contract Pharmacy Representative

CVS
John Carlson, Director
(781) 559-9636

Signed By Date

1/17/2020

340B Drug Pricing Program Database