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CVS PHARMACY, INC.
CH063450 PRESBYTERIAN MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
PRESBYTERIAN MEDICAL SERVICES, INC.
Subdivision Name
PRESBYTERIAN MEDICAL SERVICES
Type
HRSA-Funded Health Center
340B ID
CH063450
Entity Address
1422 PASEO DE PERALTA
SANTA FE, NM 87501-4391
Grant Number
H80CS00205
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA CVS/PHARMACY #10148
715 WEST BENDER BLVD.
HOBBS, NM 88240
Pharmacy Comments
Contract Details
Approval Date
7/2/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen M. Quesada, DIRECTOR OF PHARMACY
(505) 443-2634
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/2/2021
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