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CVS ALBANY, L.L.C.
DSH330285 STRONG MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
STRONG MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330285
Entity Address
601 Elmwood Avenue
ROCHESTER, NY 14642
Medicare Provider Number
330285
Participating Start Date
10/1/2003
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00755
1900 SOUTH CLINTON AVENUE
ROCHESTER, NY 14618
Pharmacy Comments
Contract Details
Approval Date
7/9/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/2/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
LEONARD J. SHUTE, SENIOR DIRECTOR OF FINANCE, CFO
(585) 275-3033
Contract Pharmacy Representative
Scott Tierney, Senior Director, Payer Relations
(401) 770-2762
Signed By Date
7/9/2013
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