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GEORGIA CVS PHARMACY, L.L.C.
CH048130 VALLEY HEALTHCARE SYSTEM, INC.
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Covered Entity Details
Entity Name
VALLEY HEALTHCARE SYSTEM, INC.
Subdivision Name
Fort Benning Road Health Center
Type
HRSA-Funded Health Center
340B ID
CH048130
Entity Address
1600 Fort Benning Road
Columbus, GA 31903-2837
Grant Number
H80CS00678
Participating Start Date
7/1/2006
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
GEORGIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04677
3617 HILTON AVE.
COLUMBUS, GA 31904
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SARAH E. LANG, CEO
(706) 322-9599 Ext: 1011
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2022
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