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OHIO CVS STORES, L.L.C.
CH050580 NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Subdivision Name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH050580
Entity Address
8300 Hough Ave
Cleveland, OH 44103-4247
Grant Number
H80CS00191
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03337
3825 MONTICELLO BLVD
CLEVELAND HEIGHTS, OH 44121
Pharmacy Comments
Contract Details
Approval Date
1/28/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Willie F. Austin, President/CEO
(216) 231-7700 Ext: 1112
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/28/2021
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