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EDC DRUG STORES, INC.
CH043270 EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Subdivision Name
EAU CLAIRE COOPERATIVE HEALTH CENTER ADMINISTRATIVE OFFICES
Type
HRSA-Funded Health Center
340B ID
CH043270
Entity Address
221 Dawson Road
COLUMBIA, SC 29223
Grant Number
H80CS00730
Participating Start Date
4/1/2002
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
EDC DRUG STORES, INC.
Pharmacy Address
RITE AID #11582
5900 NORTH MAIN STREET
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
7/9/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/23/2018
Ownership change
Contacts
Covered Entity Signing Official
STUART A. HAMILTON, CEO
(803) 733-5969 Ext: 4125
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
7/9/2013
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