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PENNSYLVANIA CVS PHARMACY, L.L.C.
STD19143 Courage Medicine Health Center Inc
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Covered Entity Details
Entity Name
Courage Medicine Health Center Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD19143
Entity Address
3045 Kensington Avenue
Philadelphia, PA 19134
Grant Number
NH25PS005233-01-00
Participating Start Date
1/1/2024
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02266
6900 LINDBERGH BLVD.
PHILADELPHIA, PA 19142
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
Trisha Acri, Finance Director/Medical Director
(215) 990-7853
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2025
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