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CVS ALBANY, L.L.C.
DSH330028 RICHMOND UNIVERSITY MEDICAL CENTER
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Covered Entity Details
Entity Name
RICHMOND UNIVERSITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330028
Entity Address
355 BARD AVENUE
STATEN ISLAND, NY 10310
Medicare Provider Number
330028
Participating Start Date
11/17/2005
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06054
2465 RICHMOND AVE.
STATEN ISLAND, NY 10314
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Stephen Murray, Chief Financial Officer
(718) 818-3295
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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