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MISSOURI CVS PHARMACY, L.L.C.
CHC08748-06 COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI
Subdivision Name
Community Health Center of Central Missouri - Christy Drive
Type
HRSA-Funded Health Center
340B ID
CHC08748-06
Entity Address
1511 Christy Drive
Jefferson City, MO 65101-2854
Grant Number
H80CS08748
Participating Start Date
7/1/2018
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #11315
600 COURT STREET
FULTON, MO 65251
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
Toby Barnett, CFO
(573) 632-0243
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/9/2020
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