Contract Pharmacy Details

DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C
RWI20005 MetroHealth

Covered Entity Details

Entity Name

MetroHealth

Subdivision Name

Type

Ryan White Part A

340B ID

RWI20005

Entity Address

1012 14th Street, NW
Suite 700
Washington, DC 20005

Grant Number

H89HA00012

Participating Start Date

10/1/2019

Last Recertification Date

2/23/2022

Entity Termination Date

4/1/2023

Pharmacy Details

Pharmacy Name

DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C

Pharmacy Address

DBA: CVS/PHARMACY # 07218
400 MASSACHUSETTS AVE., NW
WASHINGTON, DC 20001

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

4/1/2023
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Miguel McInnis, CEO
(202) 838-9271

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/14/2020

340B Drug Pricing Program Database