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NEW JERSEY CVS PHARMACY, L.L.C.
CH03122A N PENN COMPREHENSIVE HEALTH SVCS
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Covered Entity Details
Entity Name
N PENN COMPREHENSIVE HEALTH SVCS
Subdivision Name
WELLSBORO LAUREL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH03122A
Entity Address
7 Water Street
Wellsboro, PA 16901-1358
Grant Number
H80CS00682
Participating Start Date
1/1/2009
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
NEW JERSEY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 7961
524 MULLICA HILL RD
MULLICA HILL, NJ 08062
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ronald M Gilbert, CFO
(570) 828-3869
Contract Pharmacy Representative
CVS Pharmacies
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
4/14/2022
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