Contract Pharmacy Details

GIANT EAGLE PHARMACY #4060
CHC33659-00 My Community Health Center

Covered Entity Details

Entity Name

My Community Health Center

Subdivision Name

My Community Health Center - Canton

Type

HRSA-Funded Health Center

340B ID

CHC33659-00

Entity Address

2600 7th St. SW
Canton, OH 44710-0000

Grant Number

H80CS33659

Participating Start Date

4/1/2020

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

GIANT EAGLE PHARMACY #4060

Pharmacy Address

6493 STRIP AVENUE, NW
NORTH CANTON, OH 44720

Pharmacy Comments

Contract Details

Approval Date

1/4/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/16/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Terry Regula, CEO
(330) 363-3179

Contract Pharmacy Representative

Giant Eagle, Inc.
Mike Bianco, Senior Pharmacy Manager
(412) 967-3718

Signed By Date

1/4/2021

340B Drug Pricing Program Database