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PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03414C SPECTRUM HEALTH SERVICES
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Covered Entity Details
Entity Name
SPECTRUM HEALTH SERVICES
Subdivision Name
Cottman Avenue Health Center
Type
HRSA-Funded Health Center
340B ID
CH03414C
Entity Address
3525 Cottman Ave
Philadelphia, PA 19149-1607
Grant Number
H80CS00389
Participating Start Date
4/1/2023
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02222
7520 CITY LINE AVE.
PHILADELPHIA, PA 19151
Pharmacy Comments
Contract Details
Approval Date
4/9/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shawna L Russell-Young, Chief Compliance Officer
(215) 668-0847
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/9/2025
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