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CVS PHARMACY, INC.
CH011640 MANET COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
MANET COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
MANET COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH011640
Entity Address
110 W Squantum St
Quincy, MA 02171-2122
Grant Number
H80CS00453
Participating Start Date
4/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA CVS/PHARMACY #10932
330 COURT ST.
PLYMOUTH, MA 02360
Pharmacy Comments
Contract Details
Approval Date
6/2/2023
Contract Begin Date
6/2/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Athelstane Seraphin, CFO
(774) 409-0492
Contract Pharmacy Representative
CVS Health
Robert Hoffman, Account Manager
(845) 768-6635
Signed By Date
6/2/2023
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