Contract Pharmacy Details

CVS ALBANY, L.L.C.
CH022070 ANTHONY L JORDAN HEALTH CORP

Covered Entity Details

Entity Name

ANTHONY L JORDAN HEALTH CORP

Subdivision Name

Main Site

Type

HRSA-Funded Health Center

340B ID

CH022070

Entity Address

82 Holland St
Rochester, NY 14605-2131

Grant Number

H80CS21582

Participating Start Date

10/1/2011

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00466
685 PARK AVENUE
ROCHESTER, NY 14607

Pharmacy Comments

Contract Details

Approval Date

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/24/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jonathan Clune, CFO
(585) 423-2813

Contract Pharmacy Representative

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

Signed By Date

7/15/2020

340B Drug Pricing Program Database