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MARYLAND CVS PHARMACY, L.L.C.
CHC10591-00 COMMUNITY CLINIC, INC.
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Covered Entity Details
Entity Name
COMMUNITY CLINIC, INC.
Subdivision Name
CCI-Takoma Park
Type
HRSA-Funded Health Center
340B ID
CHC10591-00
Entity Address
7676 NEW HAMPSHIRE AVENUE
Suite 200
TAKOMA PARK, MD 20912
Grant Number
H80CS10591
Participating Start Date
4/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MARYLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01468
10141 COLESVILLE ROAD
SILVER SPRING, MD 20901
Pharmacy Comments
Contract Details
Approval Date
4/18/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sonya J. Bruton, CEO and President
(240) 839-5107
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/18/2023
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