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DAVIES PHARMACY
CH053086A Lifecare Family Health & Dental Center, Inc.
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Covered Entity Details
Entity Name
Lifecare Family Health & Dental Center, Inc.
Subdivision Name
Lincoln Street Health Center
Type
HRSA-Funded Health Center
340B ID
CH053086A
Entity Address
2725 Lincoln St E
Canton, OH 44707-2769
Grant Number
H80CS06654
Participating Start Date
4/1/2008
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
DAVIES PHARMACY
Pharmacy Address
2915 TUSCARAWAS ST W
STEVE FETTMAN RPH
CANTON, OH 44708-4607
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/14/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Janet C McPeek, CEO
(234) 521-7213
Contract Pharmacy Representative
Davies Pharmacy
Steven Fettman, Owner
(330) 454-5151
Signed By Date
1/14/2022
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