Contract Pharmacy Details

OHIO CVS STORES, L.L.C.
CH050990 HEALTHSOURCE OF OHIO, INC.

Covered Entity Details

Entity Name

HEALTHSOURCE OF OHIO, INC.

Subdivision Name

HEALTHSOURCE OF OHIO, INC.

Type

HRSA-Funded Health Center

340B ID

CH050990

Entity Address

424 WARDS CORNER STE 200
LOVELAND, OH 45140-6966

Grant Number

H80CS00201

Participating Start Date

10/1/1998

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

OHIO CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 02764
7314 MONTGOMERY RD.
CINCINNATI, OH 45236

Pharmacy Comments

Contract Details

Approval Date

1/14/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/31/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

KIM PATTON, CEO
(513) 576-7700

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/14/2020

340B Drug Pricing Program Database