Contract Pharmacy Details

DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C
STD20012 Casa Ruby Inc.

Covered Entity Details

Entity Name

Casa Ruby Inc.

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD20012

Entity Address

7530 Georgia Ave NW
Washington, DC 20012

Grant Number

NH25PS005133-02-03

Participating Start Date

8/13/2021

Last Recertification Date

Entity Termination Date

7/1/2022

Pharmacy Details

Pharmacy Name

DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C

Pharmacy Address

DBA: CVS/PHARMACY # 01349
5227 GEORGIA AVENUE NW
WASHINGTON, DC 20011

Pharmacy Comments

Contract Details

Approval Date

10/20/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Ruby Corado, Executive Director
(202) 641-8028

Contract Pharmacy Representative

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

Signed By Date

10/20/2021

340B Drug Pricing Program Database