Contract Pharmacy Details

CVS ALBANY, L.L.C.
RRC330226-00 THE UNITY HOSPITAL OF ROCHESTER

Covered Entity Details

Entity Name

THE UNITY HOSPITAL OF ROCHESTER

Subdivision Name

Type

Rural Referral Center

340B ID

RRC330226-00

Entity Address

1555 LONG POND ROAD
ROCHESTER, NY 14626

Medicare Provider Number

330226

Participating Start Date

9/1/2021

Last Recertification Date

Entity Termination Date

3/15/2022

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00575
259 WEST MAIN ST.,
BATAVIA, NY 14020

Pharmacy Comments

Contract Details

Approval Date

9/2/2021

Contract Begin Date

9/2/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/15/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941

Contract Pharmacy Representative

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

Signed By Date

9/2/2021

340B Drug Pricing Program Database