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PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03362C LANCASTER HEALTH CENTER
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Covered Entity Details
Entity Name
LANCASTER HEALTH CENTER
Subdivision Name
Lancaster Health Center - Reynolds Middle School
Type
HRSA-Funded Health Center
340B ID
CH03362C
Entity Address
605 W WALNUT ST
LANCASTER, PA 17603-3306
Grant Number
H80CS00686
Participating Start Date
4/1/2016
Last Recertification Date
2/4/2021
Entity Termination Date
7/1/2021
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01675
1278 MILLERSVILLE PIKE
LANCASTER, PA 17603
Pharmacy Comments
Contract Details
Approval Date
10/10/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Alisa Jones, President and CEO
(717) 945-1551
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/10/2019
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