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CVS PHARMACY, INC.
DSH450352 Hunt Regional Medical Center
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Covered Entity Details
Entity Name
Hunt Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450352
Entity Address
4215 Joe Ramsey Blvd
Greenville, TX 75401
Medicare Provider Number
450352
Participating Start Date
1/1/2013
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA CVS/PHARMACY #10505
2710 HIGHWAY 24
COMMERCE, TX 75428
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Ayers Robertson, Chief Financial Officer
(903) 408-1607
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2022
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