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CVS ALBANY, L.L.C.
DSH330226 UNITY HOSPITAL OF ROCHESTER
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Covered Entity Details
Entity Name
UNITY HOSPITAL OF ROCHESTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330226
Entity Address
1555 LONG POND ROAD
ROCHESTER, NY 14626
Medicare Provider Number
330226
Participating Start Date
3/15/2022
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00739
1455 LAKE AVE
CORN FLOWER CITY PARKWAY
ROCHESTER, NY 14615
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/2/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941
Contract Pharmacy Representative
CVS
Kathryn Ficca, Account Manager
(401) 772-7339
Signed By Date
4/14/2020
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