Contract Pharmacy Details

CVS ALBANY, L.L.C.
DSH330394 UNITED HEALTH SERVICES HOSPITALS, INC.

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 # 00168
800 HOOPER RD., SUITE 500
ENDWELL, NY 13760

Pharmacy Comments

Contract Details

Approval Date

10/7/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/31/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Dave MacDougall, Senior Vice President and CFO
(607) 762-3006

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/7/2015

340B Drug Pricing Program Database