Contract Pharmacy Details

IOWA CVS PHARMACY, L.L.C.
RWII61265A The Project of the Quad Cities

Covered Entity Details

Entity Name

The Project of the Quad Cities

Subdivision Name

Type

Ryan White Part B

340B ID

RWII61265A

Entity Address

4101 John Deere Road
Moline, IL 61265

Grant Number

X09HA32739

Participating Start Date

10/1/2016

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

IOWA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08659
1777 DIVISION ST.
DAVENPORT, IA 52804

Pharmacy Comments

Contract Details

Approval Date

7/12/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/24/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

Caitlin Brady Wells, Chief Executive Officer
(309) 581-2030

Contract Pharmacy Representative

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

Signed By Date

7/12/2022

340B Drug Pricing Program Database