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NORTH CAROLINA CVS PHARMACY, L.L.C.
CH041000 Advance Community Health, Inc.
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Covered Entity Details
Entity Name
Advance Community Health, Inc.
Subdivision Name
Southeast Raleigh - South
Type
HRSA-Funded Health Center
340B ID
CH041000
Entity Address
1011 Rock Quarry Rd
Raleigh, NC 27610
Grant Number
H80CS00087
Participating Start Date
7/1/2001
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02313
2340 SPRING FOREST ROAD
RALEIGH, NC 27615
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Penella M. Washington, CEO
(919) 250-2923
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2019
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