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CVS PHARMACY, INC.
CH010860 NORTH SHORE COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
NORTH SHORE COMMUNITY HEALTH CENTER, INC
Subdivision Name
SALEM FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH010860
Entity Address
47 Congress St
Salem, MA 01970-7308
Grant Number
H80CS00494
Participating Start Date
10/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 01204
509 EASTERN AVENUE
LYNN, MA 01902
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marc Bourassa, CFO
(978) 825-1155
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/14/2021
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