Contract Pharmacy Details

CVS PHARMACY, INC.
HV001230 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Arlington

Type

Ryan White Part C

340B ID

HV001230

Entity Address

601 Matlock Centre Circle
Arlington, TX 76015

Grant Number

H76HA00123

Participating Start Date

10/1/2020

Last Recertification Date

3/10/2025

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA: CVS/PHARMACY # 05962
3200 TEASLEY LN.
DENTON, TX 76210

Pharmacy Comments

Contract Details

Approval Date

1/15/2021

Contract Begin Date

4/1/2021

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

1/15/2021

340B Drug Pricing Program Database