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NORTH CAROLINA CVS PHARMACY, L.L.C.
CH046680 RURAL HEALTH GROUP, INC.
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Covered Entity Details
Entity Name
RURAL HEALTH GROUP, INC.
Subdivision Name
Rural Health Group at Jackson
Type
HRSA-Funded Health Center
340B ID
CH046680
Entity Address
9425 NC HIGHWAY 305
JACKSON, NC 27845-9679
Grant Number
H80CS00866
Participating Start Date
10/1/2003
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03387
1124 E 10TH ST
ROANOKE RAPIDS, NC 27870
Pharmacy Comments
Contract Details
Approval Date
4/6/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/3/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
BRIAN O. HARRIS, CEO
(252) 536-5929
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/6/2017
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