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CVS ALBANY, L.L.C.
RRC330164-00 HIGHLAND HOSPITAL OF ROCHESTER
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Covered Entity Details
Entity Name
HIGHLAND HOSPITAL OF ROCHESTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330164-00
Entity Address
1000 South Avenue
ROCHESTER, NY 14620
Medicare Provider Number
330164
Participating Start Date
4/1/2017
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17556
3181 CHILI AVE
ROCHESTER, NY 14624
Pharmacy Comments
Contract Details
Approval Date
10/12/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carrie Fuller Spencer, Chief Financial Officer
(585) 275-3033
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/12/2021
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