Contract Pharmacy Details

CVS ALBANY, L.L.C.
FQHCLA344F Tri-County Family Medicine Program, Inc.

Covered Entity Details

Entity Name

Tri-County Family Medicine Program, Inc.

Subdivision Name

TCFM Canaseraga

Type

Health Center Program Look-Alike

340B ID

FQHCLA344F

Entity Address

12 N Church St
Canaseraga, NY 14822-9721

Grant Number

LALCS00181

Participating Start Date

7/1/2022

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05072
225 MAIN STREET
DANSVILLE, NY 14437

Pharmacy Comments

Contract Details

Approval Date

7/7/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Nicholas H Apostoleris, CSIO
(585) 432-2300

Contract Pharmacy Representative

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

Signed By Date

7/7/2022

340B Drug Pricing Program Database