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PENNSYLVANIA CVS PHARMACY, L.L.C.
CH031839B Esperanza Health Center, Inc.
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Covered Entity Details
Entity Name
Esperanza Health Center, Inc.
Subdivision Name
ESPERANZA HEALTH CENTER K&A
Type
HRSA-Funded Health Center
340B ID
CH031839B
Entity Address
861 E. Allegheny Ave
Philadelphia, PA 19134-2400
Grant Number
H80CS06644
Participating Start Date
10/1/2007
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02074
4133 G ST.
PHILADELPHIA, PA 19124
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Juan Perez, COO
(215) 807-8616
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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