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CVS ALBANY, L.L.C.
DSH330096 JONES MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
JONES MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330096
Entity Address
191 North Main Street
WELLSVILLE, NY 14895-0072
Medicare Provider Number
330096
Participating Start Date
10/1/2017
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00539
415 N. UNION ST.
OLEAN, NY 14760
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
4/21/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Helms, Vice President of Finance
(585) 596-4002
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2020
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