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PENNSYLVANIA CVS PHARMACY, L.L.C.
CHC24140-00 Southern Tier Community Health Center Network
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Covered Entity Details
Entity Name
Southern Tier Community Health Center Network
Subdivision Name
Southern Tier Community Health Center Network, Olean site
Type
HRSA-Funded Health Center
340B ID
CHC24140-00
Entity Address
135 N. Union St.
Olean, NY 14760-2736
Grant Number
H80CS24140
Participating Start Date
3/1/2013
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04270
10 DAVIS ST
BRADFORD, PA 16701
Pharmacy Comments
Contract Details
Approval Date
4/8/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Angela Langdon, COO
(716) 701-6828
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/8/2020
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