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CVS ALBANY, L.L.C.
DSH330394 UNITED HEALTH SERVICES HOSPITALS, INC.
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Covered Entity Details
Entity Name
UNITED HEALTH SERVICES HOSPITALS, INC.
Subdivision Name
Binghamton General Hospital
Type
Disproportionate Share Hospital
340B ID
DSH330394
Entity Address
10-42 MITCHELL AVENUE
BINGHAMTON, NY 13903
Medicare Provider Number
330394
Participating Start Date
9/4/2009
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02180
163 ROBINSON STREET
BINGHAMTON, NY 13904
Pharmacy Comments
Contract Details
Approval Date
4/14/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERT G. GOMULKA, SR. VP FISCAL SERVICES/CFO & TREASURER
(607) 762-3006
Contract Pharmacy Representative
CVS Caremark
Anthony Gratto, 340B Vendor Manager
(401) 770-7298
Signed By Date
4/14/2014
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