Contract Pharmacy Details

CVS PHARMACY, INC.
RWII02657 Provincetown AIDS Support Group d.b.a. AIDS Support Group of Cape Cod

Covered Entity Details

Entity Name

Provincetown AIDS Support Group d.b.a. AIDS Support Group of Cape Cod

Subdivision Name

Type

Ryan White Part B

340B ID

RWII02657

Entity Address

96-98 Bradford Street
Provincetown, MA 02657

Grant Number

X07HA00082

Participating Start Date

4/1/2015

Last Recertification Date

2/28/2025

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA: CVS/PHARMACY # 00636
65 ROUTE 6A
SANDWICH, MA 02563-1893

Pharmacy Comments

Contract Details

Approval Date

10/6/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Heather Murphy, Chief Programs Officer
(413) 237-5296

Contract Pharmacy Representative

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

Signed By Date

10/6/2023

340B Drug Pricing Program Database