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RHODE ISLAND CVS PHARMACY, L.L.C.
HV02895 THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
Thundermist Ryan White Part C Woonsocket
Type
Ryan White Part C
340B ID
HV02895
Entity Address
450 CLINTON STREET
WOONSOCKET, RI 02895
Grant Number
H76HA00704
Participating Start Date
10/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
RHODE ISLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07387
63 NEWPORT AVE
RUMFORD, RI 02916
Pharmacy Comments
Contract Details
Approval Date
10/7/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alyssa Bruno, Practice Director
(401) 356-4428
Contract Pharmacy Representative
CVS Pharmacies
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
10/7/2022
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