Contract Pharmacy Details

OHIO CVS STORES, L.L.C.
CHC12892-03 ROCKING HORSE CENTER

Covered Entity Details

Entity Name

ROCKING HORSE CENTER

Subdivision Name

Rocking Horse Center - Madison County

Type

HRSA-Funded Health Center

340B ID

CHC12892-03

Entity Address

212 N MAIN ST
LONDON, OH 43140-1115

Grant Number

H80CS12892

Participating Start Date

1/1/2016

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

OHIO CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06191
214 LAFAYETTE ST.
LONDON, OH 43140

Pharmacy Comments

Contract Details

Approval Date

10/14/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kent Youngman, CEO
(937) 324-1111 Ext: 190

Contract Pharmacy Representative

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

Signed By Date

10/14/2020

340B Drug Pricing Program Database