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CVS ALBANY, L.L.C.
CAH221302-00 FAIRVIEW HOSPITAL
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Covered Entity Details
Entity Name
FAIRVIEW HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH221302-00
Entity Address
29 LEWIS AVE
GREAT BARRINGTON, MA 01230
Medicare Provider Number
221302
Participating Start Date
9/27/2010
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00424
160 FAIRVIEW AVE. STE 20
HUDSON, NY 12534
Pharmacy Comments
Contract Details
Approval Date
4/13/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DARLENE RODOWICZ, Executive Vice President & Treasurer
(413) 447-2809
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/13/2020
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