340B Drug Pricing Program Database
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CVS ALBANY, L.L.C.
DSH330239 UPMC CHAUTAUQUA AT WCA
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Covered Entity Details
Entity Name
UPMC CHAUTAUQUA AT WCA
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330239
Entity Address
207 Foote Avenue
JAMESTOWN, NY 14701
Medicare Provider Number
330239
Participating Start Date
10/1/2019
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05089
10 SOUTH WORK ST.
FALCONER, NY 14733
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
Brad N Dinger, CFO
(814) 877-3739
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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