Contract Pharmacy Details

GEORGIA CVS PHARMACY, L.L.C.
CH040390 MEDLINK GEORGIA, INC.

Covered Entity Details

Entity Name

MEDLINK GEORGIA, INC.

Subdivision Name

Medlink Colbert

Type

HRSA-Funded Health Center

340B ID

CH040390

Entity Address

11 CHARLIE MORRIS RD
COLBERT, GA 30628

Grant Number

H80CS00427

Participating Start Date

7/1/2005

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

GEORGIA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY # 4164
1680 OLD PENDERGRASS RD.
JEFFERSON, GA 30549

Pharmacy Comments

Contract Details

Approval Date

4/5/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Dave Ward, CEO
(706) 788-3234

Contract Pharmacy Representative

CVS Health
Jaclyn Parfitt, 340B Operations Manager
(401) 770-6467

Signed By Date

4/5/2021

340B Drug Pricing Program Database