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SOUTH CAROLINA CVS PHARMACY, L.L.C.
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
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05596
4627 NORTH MAIN STREET
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
10/13/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
STUART A. HAMILTON, CEO
(803) 733-5969 Ext: 4125
Contract Pharmacy Representative
CVS Health
Jaclyn Parfitt, 340B Operations Manager
(401) 770-6467
Signed By Date
10/13/2015
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