Contract Pharmacy Details

NEW JERSEY CVS PHARMACY, L.L.C.
RWI07834 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Denville

Type

Ryan White Part A

340B ID

RWI07834

Entity Address

295 E Main Street
#315
Denville, NJ 07834

Grant Number

H89HA00003

Participating Start Date

7/1/2019

Last Recertification Date

2/16/2024

Entity Termination Date

7/1/2024

Pharmacy Details

Pharmacy Name

NEW JERSEY CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01956
514 PARK AVE
SCOTCH PLAINS CENTER
SCOTCH PLAINS, NJ 07076

Pharmacy Comments

Contract Details

Approval Date

4/17/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111

Contract Pharmacy Representative

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

Signed By Date

4/17/2020

340B Drug Pricing Program Database