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DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C
CH03682A LA CLINICA DEL PUEBLO, INC.
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Covered Entity Details
Entity Name
LA CLINICA DEL PUEBLO, INC.
Subdivision Name
La Clinica del Pueblo - Hyattsville Site
Type
HRSA-Funded Health Center
340B ID
CH03682A
Entity Address
2970 Belcrest Center Drive, Suite #301
Hyattsville, MD 20782-2078
Grant Number
H80CS08244
Participating Start Date
4/1/2017
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C
Pharmacy Address
CVS/PHARMACY # 10833
1101 NEW YORK AVE, NW
WASHINGTON, DC 20005
Pharmacy Comments
Contract Details
Approval Date
7/18/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carlos Plazas, CFO/COO
(202) 464-0141
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/18/2024
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