Contract Pharmacy Details

CVS ALBANY, L.L.C.
FQHCLA344D Tri-County Family Medicine Program, Inc.

Covered Entity Details

Entity Name

Tri-County Family Medicine Program, Inc.

Subdivision Name

TCFM Cohocton

Type

Health Center Program Look-Alike

340B ID

FQHCLA344D

Entity Address

25 Park Ave
Cohocton, NY 14826-9401

Grant Number

LALCS00181

Participating Start Date

1/1/2017

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01925
1259 ROUTE 332
FARMINGTON, NY 14425

Pharmacy Comments

Contract Details

Approval Date

1/14/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Nicholas H Apostoleris, CSIO
(585) 432-2300

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/14/2021

340B Drug Pricing Program Database