Contract Pharmacy Details

CVS ALBANY, L.L.C.
CHC26630-05 JERICHO ROAD MINISTRIES INC.

Covered Entity Details

Entity Name

JERICHO ROAD MINISTRIES INC.

Subdivision Name

Jericho Road Community Health Center Breckenridge

Type

HRSA-Funded Health Center

340B ID

CHC26630-05

Entity Address

182 Breckenridge St
Buffalo, NY 14213-1562

Grant Number

H80CS26630

Participating Start Date

10/1/2021

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00609
1625 ELMWOOD AVE.
SPECTRUM BLDG
BUFFALO, NY 14207

Pharmacy Comments

Contract Details

Approval Date

7/7/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Myron Glick, Chief Executive Officer
(716) 348-3000

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/7/2023

340B Drug Pricing Program Database