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SOUTH CAROLINA CVS PHARMACY, L.L.C.
CAH421301-00 ABBEVILLE COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
ABBEVILLE COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH421301-00
Entity Address
420 THOMSON CIRCLE
ABBEVILLE, SC 29620
Medicare Provider Number
421301
Participating Start Date
8/19/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04111
2814 N MAIN ST.
ANDERSON, SC 29621
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TIMOTHY WREN, CFO
(864) 366-3310
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2019
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