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PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03048E B-K Health Center, Inc.
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Covered Entity Details
Entity Name
B-K Health Center, Inc.
Subdivision Name
NEPA Community Health Care-Hallstead
Type
HRSA-Funded Health Center
340B ID
CH03048E
Entity Address
25066 State Route 11
Hallstead, PA 18822
Grant Number
H80CS00420
Participating Start Date
7/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
CVS/PHARMACY #11422
177 ERIE BLVD
SUSQUEHANNA, PA 18847-2791
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/4/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Mary W. Wetherall, CEO
(570) 278-5161
Contract Pharmacy Representative
Wellpartner
Isis Cantu, Account Manager
(401) 772-7324
Signed By Date
7/7/2020
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