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DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C
RWII20010 District of Columbia Department of Health
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Covered Entity Details
Entity Name
District of Columbia Department of Health
Subdivision Name
Us Helping Us, People Into Living Inc.
Type
Ryan White Part B
340B ID
RWII20010
Entity Address
3636 Georgia Ave. NW
Washington, DC 20010
Grant Number
X07HA00045
Participating Start Date
7/1/2020
Last Recertification Date
2/8/2022
Entity Termination Date
7/1/2022
Pharmacy Details
Pharmacy Name
DISTRICT OF COLUMBIA CVS PHARMACY, L.L.C
Pharmacy Address
DBA: CVS/PHARMACY # 02834
3031 14TH ST., NW
WASHINGTON, DC 20009
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
DeMarc Anthony Hickson, Executive Director
(202) 446-1100 Ext: 1092
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/13/2018
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