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CVS ALBANY, L.L.C.
RRC330164-00 HIGHLAND HOSPITAL OF ROCHESTER
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Covered Entity Details
Entity Name
HIGHLAND HOSPITAL OF ROCHESTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330164-00
Entity Address
1000 South Avenue
ROCHESTER, NY 14620
Medicare Provider Number
330164
Participating Start Date
4/1/2017
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00466
685 PARK AVENUE
ROCHESTER, NY 14607
Pharmacy Comments
Contract Details
Approval Date
3/16/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Segerson, Director of Finance
(585) 341-6686
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
3/16/2017
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