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PENNSYLVANIA CVS PHARMACY, L.L.C.
RWI19403A Family Service of Montgomery County, Pennsylvania
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Covered Entity Details
Entity Name
Family Service of Montgomery County, Pennsylvania
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19403A
Entity Address
1976 East High Street
Pottstown, PA 19464-3277
Grant Number
H89HA00013
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02688
55 PARK AVE.
COLLEGEVILLE, PA 19426
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
2/22/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tim O'Connell, Dir. Special Projects
(610) 630-2111 Ext: 224
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2021
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