Contract Pharmacy Details

CVS ALBANY, L.L.C.
DSH330199 METROPOLITAN HOSPITAL CENTER (NYCHHC)

Covered Entity Details

Entity Name

METROPOLITAN HOSPITAL CENTER (NYCHHC)

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH330199

Entity Address

1901 FIRST AVE.
NEW YORK, NY 10029

Medicare Provider Number

330199

Participating Start Date

7/1/1993

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

CVS/PHARMACY # 10970
305 EAST 86TH ST.
NEW YORK, NY 10028

Pharmacy Comments

Contract Details

Approval Date

4/15/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/2/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Paul Albertson, Vice President
(212) 748-2256

Contract Pharmacy Representative

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

Signed By Date

4/15/2021

340B Drug Pricing Program Database