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CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
CHC26634-00 PHILADELPHIA FIGHT
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Covered Entity Details
Entity Name
PHILADELPHIA FIGHT
Subdivision Name
Philadelphia FIGHT Jonathan Lax Treatment Center
Type
HRSA-Funded Health Center
340B ID
CHC26634-00
Entity Address
1233 Locust Street Floor 5, Suite 500 and Floor 4, Suite 400
Philadelphia, PA 19107-5453
Grant Number
H80CS26634
Participating Start Date
4/1/2014
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
Pharmacy Address
DBA CVS/CAREMARK 48067
1780 WALL ST
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
10/2/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANE SHULL, EXECUTIVE DIRECTOR
(215) 985-4448 Ext: 102
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/2/2024
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