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MARYLAND CVS PHARMACY, L.L.C.
RWI20036 Washington Health Institute
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Covered Entity Details
Entity Name
Washington Health Institute
Subdivision Name
Infectious diseases
Type
Ryan White Part A
340B ID
RWI20036
Entity Address
1330 New Hampshire Ave NW
121
Washington, DC 20036
Grant Number
H89HA00012
Participating Start Date
12/1/2022
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
MARYLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01495
11729 BELTSVILLE DR
CALVERTON S/C
BELTSVILLE, MD 20705
Pharmacy Comments
Contract Details
Approval Date
12/1/2022
Contract Begin Date
12/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jose Bordon, Chief Executive Officer
(240) 426-8890
Contract Pharmacy Representative
CVS
Christian Reed, Sr. Director
(401) 770-2118
Signed By Date
11/17/2022
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