340B Drug Pricing Program Database
PENNSYLVANIA CVS PHARMACY, L.L.C.
CHC24159-00 River Valley Health - information as of 6/3/2025 11:16:50 AM
Covered Entity Details
Entity Name
River Valley Health
Subdivision Name
River Valley Health - Williamsport Medical and Dental
Type
HRSA-Funded Health Center
340B ID
CHC24159-00
Entity Address
471 Hepburn St
Williamsport, PA 17701-6122
Grant Number
H80CS24159
Participating Start Date
4/1/2013
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17493
170 S LYCOMING MALL RD
MUNCY, PA 17756
Pharmacy Comments
Contract Details
Approval Date
4/7/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jim Yoxtheimer, President & CEO
(570) 567-5412
Contract Pharmacy Representative
Wellpartner
Bryn Wolgemuth, Account Manager
(917) 607-0428
Signed By Date
4/7/2022
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