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MARYLAND CVS PHARMACY, L.L.C.
CH030150 Total Health Care, Inc.
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Covered Entity Details
Entity Name
Total Health Care, Inc.
Subdivision Name
Division Health Center
Type
HRSA-Funded Health Center
340B ID
CH030150
Entity Address
1501 DIVISION STREET
BALTIMORE, MD 21217
Grant Number
H80CS00068
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MARYLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03976
2509-2523 PENNSYLVANIA AVE.
BALTIMORE, MD 21217
Pharmacy Comments
Contract Details
Approval Date
11/8/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Faye Royale-Larkins, CEO
(410) 728-4090
Contract Pharmacy Representative
cvs
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
11/8/2017
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