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KANSAS CVS PHARMACY, L.L.C.
CHC28960-00 ATCHISON COMMUNITY HEALTH CLINIC
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Covered Entity Details
Entity Name
ATCHISON COMMUNITY HEALTH CLINIC
Subdivision Name
Atchison Community Health Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28960-00
Entity Address
1412 N 2nd St
Atchison, KS 66002-1203
Grant Number
H80CS28960
Participating Start Date
4/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KANSAS CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05889
400 SOUTH 10TH ST.
ATCHISON, KS 66002
Pharmacy Comments
Contract Details
Approval Date
1/13/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen Scott Durkin, Executive Director
(913) 367-4879
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2021
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