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PENNSYLVANIA CVS PHARMACY, L.L.C.
CHC00495-00 Union Community Care
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Covered Entity Details
Entity Name
Union Community Care
Subdivision Name
Lebanon Medical and Pharmacy
Type
HRSA-Funded Health Center
340B ID
CHC00495-00
Entity Address
920 Church St
Lebanon, PA 17046-4656
Grant Number
H80CS00495
Participating Start Date
10/1/2013
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01663
706 WEST MAIN STREET
NEW HOLLAND, PA 17557
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
Jackie Concepcion, CEO
(717) 354-4711 Ext: 136
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2019
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