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HERCHE BLOOR PHARMACY
CH056820 COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
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Covered Entity Details
Entity Name
COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
Subdivision Name
DBA LISBON COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH056820
Entity Address
7880 Lincole Pl
Lisbon, OH 44432-8322
Grant Number
H80CS00197
Participating Start Date
7/1/1997
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
HERCHE BLOOR PHARMACY
Pharmacy Address
104 E 5TH ST
EAST LIVERPOOL, OH 43920
Pharmacy Comments
Contract Details
Approval Date
7/20/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas E Andrews, CEO
(330) 424-7221 Ext: 104
Contract Pharmacy Representative
Herche Bloor
Bruno Decaria, Owner
(330) 385-0825
Signed By Date
7/20/2022
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