Contract Pharmacy Details

CVS ALBANY, L.L.C.
DSH330027 NASSAU HEALTH CARE CORPORATION

Covered Entity Details

Entity Name

NASSAU HEALTH CARE CORPORATION

Subdivision Name

Nassau University Medical Center

Type

Disproportionate Share Hospital

340B ID

DSH330027

Entity Address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW, NY 11554

Medicare Provider Number

330027

Participating Start Date

1/1/2004

Last Recertification Date

8/12/2024

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00992
403 ATLANTIC AVENUE
FREEPORT, NY 11520

Pharmacy Comments

Contract Details

Approval Date

4/13/2022

Contract Begin Date

4/28/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Richard J Rank, Director of Finance
(516) 296-2124

Contract Pharmacy Representative

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

Signed By Date

4/13/2022

340B Drug Pricing Program Database