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OHIO CVS STORES, L.L.C.
CH053086A Lifecare Family Health & Dental Center, Inc.
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Covered Entity Details
Entity Name
Lifecare Family Health & Dental Center, Inc.
Subdivision Name
Lincoln Street Health Center
Type
HRSA-Funded Health Center
340B ID
CH053086A
Entity Address
2725 Lincoln St E
Canton, OH 44707-2769
Grant Number
H80CS06654
Participating Start Date
4/1/2008
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #10372
2210 TUSCARAWAS ST. W
CANTON, OH 44708
Pharmacy Comments
Contract Details
Approval Date
7/9/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janet C McPeek, CEO
(234) 521-7213
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/9/2020
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