340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS PHARMACY, INC.
DSH320011 ESPANOLA HOSPITAL
Print
Covered Entity Details
Entity Name
ESPANOLA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH320011
Entity Address
1010 SPRUCE STREET
ESPANOLA, NM 87532
Medicare Provider Number
320011
Participating Start Date
4/1/2005
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA CVS/PHARMACY # 5994
1202 N. RIVERSIDE DR.
ESPANOLA, NM 87532
Pharmacy Comments
Contract Details
Approval Date
10/6/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DALE MAXWELL, SENIOR VP & CFO
(505) 923-5353
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/6/2016
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session