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NEW JERSEY CVS PHARMACY, L.L.C.
STD33316 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
BHC
Type
Sexually Transmitted Diseases
340B ID
STD33316
Entity Address
315 SE 14th St.
Fort Lauderdale, FL 33316
Grant Number
1 NH25PS005131-01-00
Participating Start Date
10/1/2017
Last Recertification Date
5/29/2025
Pharmacy Details
Pharmacy Name
NEW JERSEY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00478
9015 BERGENLINE AVENUE - 90TH STREET
NORTH BERGEN, NJ 07047
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
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
10/15/2020
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