Contract Pharmacy Details

CVS PHARMACY, INC.
STD33316 CAN Community Health, Inc.

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

5/27/2024

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA: CVS/PHARMACY # 06834
917 MAIN ST.
HOUSTON, TX 77002

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

340B Drug Pricing Program Database