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CVS ALBANY, L.L.C.
CH021200 BETANCES HEALTH CENTER
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Covered Entity Details
Entity Name
BETANCES HEALTH CENTER
Subdivision Name
BETANCES HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH021200
Entity Address
280 Henry St
New York, NY 10002-4816
Grant Number
H80CS00235
Participating Start Date
10/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01113
89-11 NORTHERN BLVD.
JACKSON HEIGHTS, NY 11372
Pharmacy Comments
Contract Details
Approval Date
4/1/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/2/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Julia Tsien, CEO
(212) 227-8401 Ext: 101
Contract Pharmacy Representative
CVS
Kathryn Ficca, Account Manager
(401) 772-7339
Signed By Date
4/1/2020
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