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SOUTH CAROLINA CVS PHARMACY, L.L.C.
CHC28973-00 GENESIS HEALTHCARE, INC
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Covered Entity Details
Entity Name
GENESIS HEALTHCARE, INC
Subdivision Name
Olanta Family Care
Type
HRSA-Funded Health Center
340B ID
CHC28973-00
Entity Address
211 S Jones Rd
Olanta, SC 29114-9705
Grant Number
H80CS28973
Participating Start Date
6/27/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03863
301 WEST THOMAS ST.
LAKE CITY, SC 29560
Pharmacy Comments
Contract Details
Approval Date
4/1/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tony R. Megna, CEO
(803) 254-3676
Contract Pharmacy Representative
Wellpartner
Brad Falcone, Consultant
(401) 772-7316
Signed By Date
4/1/2020
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