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CVS ALBANY, L.L.C.
CAH331314-00 SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES COUNTY
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Covered Entity Details
Entity Name
SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES COUNTY
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331314-00
Entity Address
418 NORTH MAIN STREET
PENN YAN, NY 14527
Medicare Provider Number
331314
Participating Start Date
1/1/2020
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05016
506 SOUTH FRANKLIN STREET
WATKINS GLEN, NY 14891
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Frank Michael Korich, Chief Operating Officer
(315) 787-4021
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/7/2020
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