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CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
CH011223G 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
Allen Pond Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH011223G
Entity Address
71 Allen Street Suite 403
Rutland, VT 05701
Grant Number
H80CS06659
Participating Start Date
7/1/2018
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
Pharmacy Address
DBA CVS/CAREMARK 48067
1780 WALL ST
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
10/19/2020
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
10/19/2020
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