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CVS ALBANY, L.L.C.
CH02151BK Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
LISH at Manorville
Type
HRSA-Funded Health Center
340B ID
CH02151BK
Entity Address
221 North Sunrise Service Road
Manorville, NY 11949
Grant Number
H80CS00313
Participating Start Date
1/1/2017
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05446
2000 JERICHO TURNPIKE
EAST NORTHPORT, NY 11731
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allison Dubois, COO
(914) 734-8600 Ext: 78503
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2025
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