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GEORGIA CVS PHARMACY, L.L.C.
CHC26592-00 Coastal Community Health Services, Inc.
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Covered Entity Details
Entity Name
Coastal Community Health Services, Inc.
Subdivision Name
Coastal Community Health Services
Type
HRSA-Funded Health Center
340B ID
CHC26592-00
Entity Address
106 Shoppers Way, Unit 1
Brunswick, GA 31525
Grant Number
H80CS26592
Participating Start Date
10/1/2014
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
GEORGIA CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17369
200 GLYNN ISLE
BRUNSWICK, GA 31525
Pharmacy Comments
Contract Details
Approval Date
7/8/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barbara Meyers, CEO
(912) 574-5074
Contract Pharmacy Representative
Wellpartner
Michael Petryna, National Sales Executive
(720) 377-7745
Signed By Date
7/8/2021
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