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NORTH CAROLINA CVS PHARMACY, L.L.C.
CHC00386-00 STONY CREEK COMMUNITY HEALTH CENTER INC
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Covered Entity Details
Entity Name
STONY CREEK COMMUNITY HEALTH CENTER INC
Subdivision Name
STONY CREEK COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC00386-00
Entity Address
12454 Hartley St
Stony Creek, VA 23882-3302
Grant Number
H80CS00386
Participating Start Date
7/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03387
1124 E 10TH ST
ROANOKE RAPIDS, NC 27870
Pharmacy Comments
Contract Details
Approval Date
7/6/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lucy J Elder, CEO
(434) 246-3501 Ext: 3501
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/6/2022
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