Contract Pharmacy Details

GEORGIA CVS PHARMACY, L.L.C.
FP30303 Empowerment Resource Center

Covered Entity Details

Entity Name

Empowerment Resource Center

Subdivision Name

Comprehensive Intervention Clinic

Type

Family Planning (Title X only)

340B ID

FP30303

Entity Address

230 Peachtree St NW
SUITE 1800
ATLANTA, GA 30303-1514

Grant Number

FPHPA046164

Participating Start Date

4/1/2016

Last Recertification Date

5/8/2024

Pharmacy Details

Pharmacy Name

GEORGIA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY # 10043
235 PEACHTREE ST. NE, SUITE C24
ATLANTA, GA 30303

Pharmacy Comments

Contract Details

Approval Date

10/11/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/18/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Jacqueline Brown, Chief Executive Officer
(404) 526-1145

Contract Pharmacy Representative

WellPartner
Anthony McEeachern, Anthony McEachern
(315) 314-1802

Signed By Date

10/11/2021

340B Drug Pricing Program Database