Contract Pharmacy Details

PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03362E Lancaster Health Center

Covered Entity Details

Entity Name

Lancaster Health Center

Subdivision Name

Lancaster Health Center - New Holland Avenue

Type

HRSA-Funded Health Center

340B ID

CH03362E

Entity Address

802 New Holland Avenue
Lancaster, PA 17602-2288

Grant Number

H80CS00686

Participating Start Date

1/1/2018

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

340B Drug Pricing Program Database