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RHODE ISLAND CVS PHARMACY, L.L.C.
CH011820 THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
THUNDERMIST DENTAL ADMIN WOONSOCKET
Type
HRSA-Funded Health Center
340B ID
CH011820
Entity Address
25 John A. Cummings Way
Woonsocket, RI 02895-3240
Grant Number
H80CS00454
Participating Start Date
10/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
RHODE ISLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00212
681 RESERVOIR AVENUE
CRANSTON, RI 02910
Pharmacy Comments
Contract Details
Approval Date
7/10/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeanne LaChance, President/CEO
(401) 767-4100 Ext: 3015
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/10/2019
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