Contract Pharmacy Details

MARYLAND CVS PHARMACY, L.L.C.
FQHCLA414B METRO HEALTH, INC.

Covered Entity Details

Entity Name

METRO HEALTH, INC.

Subdivision Name

600 Pennsylvania Avenue, SE

Type

Health Center Program Look-Alike

340B ID

FQHCLA414B

Entity Address

600 Pennsylvania Avenue, SE # Unit #LL1
WASHINGTON, DC 20003-4316

Grant Number

LALCS39530

Participating Start Date

4/1/2024

Last Recertification Date

Entity Termination Date

4/1/2025

Pharmacy Details

Pharmacy Name

MARYLAND CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03789
4840 MARLBORO PIKE
CAPITOL HEIGHTS, MD 20743

Pharmacy Comments

Contract Details

Approval Date

1/12/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Duane Taylor, Interim CEO and COO
(202) 638-0750 Ext: 2027744595

Contract Pharmacy Representative

Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118

Signed By Date

1/12/2024

340B Drug Pricing Program Database