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OHIO CVS STORES, L.L.C.
PED363303-00 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
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Covered Entity Details
Entity Name
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON
Subdivision Name
Type
Children's Hospital
340B ID
PED363303-00
Entity Address
ONE PERKINS SQUARE
AKRON, OH 44308-1063
Medicare Provider Number
363303
Participating Start Date
2/26/2010
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06167
418 EAST MAIN STREET
ASHLAND, OH 44805
Pharmacy Comments
Contract Details
Approval Date
12/12/2021
Contract Begin Date
12/13/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alicia Lamancusa, Vice President Finance
(330) 543-8171
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
12/12/2021
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