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CVS CAREMARK
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
CVS CAREMARK
Pharmacy Address
DBA CVS/CAREMARK OR CF# 11506
1 GREAT VALLEY BOULEVARD
WILKES BARRE, PA 18706
Pharmacy Comments
Contract Details
Approval Date
9/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kavanaugh Chandler, CEO
(912) 275-8028 Ext: 1139
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
9/15/2021
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