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HIGHLAND PARK CVS, L.L.C.
CAH141320-00 HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. (DBA Paris Community Hospital)
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Covered Entity Details
Entity Name
HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. (DBA Paris Community Hospital)
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141320-00
Entity Address
721 EAST COURT STREET
PARIS, IL 61944
Medicare Provider Number
141320
Participating Start Date
4/1/2011
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06924
102 S. STATE STREET
WESTVILLE, IL 61883
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Oliver M. Smith, CEO
(217) 465-4141 Ext: 218
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2021
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