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PENNSYLVANIA CVS PHARMACY, L.L.C.
HV032130 LEHIGH VALLEY HOSPITAL
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Covered Entity Details
Entity Name
LEHIGH VALLEY HOSPITAL
Subdivision Name
Type
Ryan White Part C
340B ID
HV032130
Entity Address
1627 Chew Street, Third Floor
Allentown, PA 18102
Grant Number
6 H76HA00078-33-04
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01942
413 RR 1, RTE 611
TANNERSVILLE, PA 18372
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Marchozzi, Executive Vice President & Chief Financial Officer
(484) 862-3943
Contract Pharmacy Representative
Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118
Signed By Date
1/14/2025
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