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CVS PHARMACY, INC.
CH010600 FENWAY COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
FENWAY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Fenway Health, Ansin Building
Type
HRSA-Funded Health Center
340B ID
CH010600
Entity Address
1340 Boylston St
Boston, MA 02215
Grant Number
H80CS00303
Participating Start Date
1/1/2004
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 01264
704 CENTRE STREET
JAMAICA PLAIN, MA 02130
Pharmacy Comments
Contract Details
Approval Date
1/17/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JEFFREY LIEBERMAN, VP of Finance
(617) 927-6173
Contract Pharmacy Representative
CVS Caremark
Anthony Gratto, 340B Vendor Manager
(401) 770-7298
Signed By Date
1/17/2014
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