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IDAHO CVS PHARMACY, L.L.C.
CH100160 COMMUNITY HEALTH CLINICS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CLINICS, INC.
Subdivision Name
TERRY REILLY HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH100160
Entity Address
211 16th Ave N
Nampa, ID 83687-4058
Grant Number
H80CS00636
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
IDAHO CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17284
16300 N MARKET PLACE BLVD
NAMPA, ID 83687
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heidi Hart, CEO
(208) 318-1255
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/14/2022
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