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MISSOURI CVS PHARMACY, L.L.C.
CH052180 RURAL HEALTH, INC.
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Covered Entity Details
Entity Name
RURAL HEALTH, INC.
Subdivision Name
ANNA MEDICAL CLINIC
Type
HRSA-Funded Health Center
340B ID
CH052180
Entity Address
513 NORTH MAIN STREET
ANNA, IL 62906
Grant Number
H80CS00711
Participating Start Date
10/1/1998
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #18074
19 S KINGSHIGHWAY
CAPE GIRARDEAU, MO 63703-5742
Pharmacy Comments
Contract Details
Approval Date
4/12/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cindy Flamm, CEO
(618) 833-4471 Ext: 1015
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2021
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