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CVS ALBANY, L.L.C.
CH021887CX Sunset Park Health Council, Inc.
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Covered Entity Details
Entity Name
Sunset Park Health Council, Inc.
Subdivision Name
Callen-Lorde at the Center
Type
HRSA-Funded Health Center
340B ID
CH021887CX
Entity Address
208 West 13th Street
New York, NY 10011
Grant Number
H80CS07914
Participating Start Date
4/1/2020
Last Recertification Date
2/15/2023
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY #07576
3101 DITMARS BLVD.
ASTORIA, NY 11105
Pharmacy Comments
Contract Details
Approval Date
1/8/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Larry K. McReynolds, Executive Director
(718) 630-7216
Contract Pharmacy Representative
CVS Health
Brennan Manning, Pharmacy Enrollment Coordinator
(401) 701-6881
Signed By Date
1/8/2021
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