Contract Pharmacy Details

SOUTH CAROLINA CVS PHARMACY, L.L.C.
DSH340061 UNC Hospitals

Covered Entity Details

Entity Name

UNC Hospitals

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH340061

Entity Address

101 MANNING DR.
CHAPEL HILL, NC 27514

Medicare Provider Number

340061

Participating Start Date

12/1/1992

Last Recertification Date

9/9/2024

Pharmacy Details

Pharmacy Name

SOUTH CAROLINA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04184
1080 ALICE DRIVE
SUMTER, SC 29150

Pharmacy Comments

Contract Details

Approval Date

4/13/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Benjamin Rowell Daniels, Chief Operating Officer
(984) 974-7744

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/13/2021

340B Drug Pricing Program Database