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SOUTH CAROLINA CVS PHARMACY, L.L.C.
CAH421304-00 Edgefield County Healthcare
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Covered Entity Details
Entity Name
Edgefield County Healthcare
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH421304-00
Entity Address
300 Ridge Medical Plaza
Edgefield, SC 29824
Medicare Provider Number
421304
Participating Start Date
7/1/2012
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03578
120 WEST COLUMBIA AVENUE
BATESBURG, SC 29006
Pharmacy Comments
Contract Details
Approval Date
4/10/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carlos Milanes, CEO
(803) 637-1150
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/10/2019
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