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UTAH CVS PHARMACY, L.L.C.
CHC28988-00 DAP HEALTH INC
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Covered Entity Details
Entity Name
DAP HEALTH INC
Subdivision Name
Desert AIDS Project, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC28988-00
Entity Address
1695 N Sunrise Way
Palm Springs, CA 92262-3701
Grant Number
H80CS28988
Participating Start Date
4/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
UTAH CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #10423
1269 E 2100 S
SALT LAKE CITY, UT 84106
Pharmacy Comments
Contract Details
Approval Date
7/8/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Brinkman, Chief Executive Officer
(760) 992-0418
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/8/2021
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