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CVS CAREMARK
CH011223F COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
Subdivision Name
CHCRR Shoreham Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH011223F
Entity Address
2987 VT Route 22A
Shoreham, VT 05770-9470
Grant Number
H80CS06659
Participating Start Date
4/1/2014
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
CVS CAREMARK
Pharmacy Address
DBA CVS/CAREMARK OR CF# 11506
1 GREAT VALLEY BOULEVARD
WILKES BARRE, PA 18706
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Gardner, CEO
(802) 855-2083
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2020
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