Contract Pharmacy Details

MONTANA CVS PHARMACY, L.L.C.
CH083270 BUTTE-SILVER BOW PRIMARY HEALTH CARE CLINIC, INC

Covered Entity Details

Entity Name

BUTTE-SILVER BOW PRIMARY HEALTH CARE CLINIC, INC

Subdivision Name

BUTTE-SILVER BOW PRIMARY HEALTH CARE

Type

HRSA-Funded Health Center

340B ID

CH083270

Entity Address

445 Centennial Ave.
Butte, MT 59701-2870

Grant Number

H80CS00799

Participating Start Date

7/1/1998

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

MONTANA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08618
1300 E. PARK AVE.
ANACONDA, MT 59711

Pharmacy Comments

Contract Details

Approval Date

7/21/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Michele K Davis, CFO
(406) 496-6025

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/21/2020

340B Drug Pricing Program Database