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SOUTH CAROLINA CVS PHARMACY, L.L.C.
HV00789 HOPEHEALTH, INC.
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Covered Entity Details
Entity Name
HOPEHEALTH, INC.
Subdivision Name
Type
Ryan White Part C
340B ID
HV00789
Entity Address
360 N. Irby Street
FLORENCE, SC 29501
Grant Number
H76HA00789
Participating Start Date
7/1/2003
Last Recertification Date
2/20/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04071
733 S. IRBY ST.
FLORENCE, SC 29501
Pharmacy Comments
Contract Details
Approval Date
10/29/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2016
Agreement registered in error
Contacts
Covered Entity Signing Official
Carl Humphries, CEO
(843) 667-9414 Ext: 1500
Contract Pharmacy Representative
CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118
Signed By Date
10/29/2015
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