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CVS ALBANY, L.L.C.
RRC330023-00 VASSAR BROTHERS MEDICAL CENTER
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Covered Entity Details
Entity Name
VASSAR BROTHERS MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330023-00
Entity Address
45 READE PLACE
POUGHKEEPSIE, NY 12601
Medicare Provider Number
330023
Participating Start Date
3/1/2022
Last Recertification Date
8/16/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05049
2 WEST RD., P.O. BOX 514
PLEASANT VALLEY, NY 12569
Pharmacy Comments
Contract Details
Approval Date
7/18/2022
Contract Begin Date
7/27/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/23/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Karen M Steele, VP of Pharmacy Services
(845) 472-9571
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/18/2022
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