340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OHIO CVS STORES, L.L.C.
CAH361331-00 Adena Fayette Medical Center
Print
Covered Entity Details
Entity Name
Adena Fayette Medical Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH361331-00
Entity Address
1430 COLUMBUS AVE.
WASHINGTON COURT HOUSE, OH 43160
Medicare Provider Number
361331
Participating Start Date
8/9/2010
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03408
1795 COLUMBUS AVENUE
WASHINGTONCOURTHSE, OH 43160
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Marie Carlson, CFO
(740) 779-7582
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session