Contract Pharmacy Details

CVS ALBANY, L.L.C.
CH02049R William F. Ryan Community Health Center, Inc.

Covered Entity Details

Entity Name

William F. Ryan Community Health Center, Inc.

Subdivision Name

PS/IS 180: Hugo Newman College Preparatory School

Type

HRSA-Funded Health Center

340B ID

CH02049R

Entity Address

370 W 120th St
New York, NY 10027-5104

Grant Number

H80CS00061

Participating Start Date

1/1/2024

Last Recertification Date

2/5/2024

Entity Termination Date

1/1/2025

Pharmacy Details

Pharmacy Name

CVS ALBANY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 02737
115 W. 125TH STREET
NEW YORK, NY 10027

Pharmacy Comments

Contract Details

Approval Date

4/15/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Scott D. Morgan, Chief Financial Officer
(212) 769-7245

Contract Pharmacy Representative

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

Signed By Date

4/15/2024

340B Drug Pricing Program Database