Contract Pharmacy Details

STAUFFERS DRUG STORE LEBANON
CHC00495-09 Union Community Care

Covered Entity Details

Entity Name

Union Community Care

Subdivision Name

Lancaster Grandview Plaza

Type

HRSA-Funded Health Center

340B ID

CHC00495-09

Entity Address

802 New Holland Ave Ste 200
Lancaster, PA 17602-2288

Grant Number

H80CS00495

Participating Start Date

6/1/2021

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

STAUFFERS DRUG STORE LEBANON

Pharmacy Address

920 CHURCH ST
STE 100
LEBANON, PA 17046-4656

Pharmacy Comments

Contract Details

Approval Date

7/7/2021

Contract Begin Date

7/13/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/6/2021
Pharmacy closed

Contacts

Covered Entity Signing Official

Alisa Jones, CEO
(717) 945-1551

Contract Pharmacy Representative

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

Signed By Date

7/7/2021

340B Drug Pricing Program Database