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DAVIS BROTHERS PHARMACY - CHESTER
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
DAVIS BROTHERS PHARMACY - CHESTER
Pharmacy Address
559 CAROLINA AVE STE B
CHESTER, WV 26034
Pharmacy Comments
Contract Details
Approval Date
7/20/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/25/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Thomas E Andrews, CEO
(330) 424-7221 Ext: 104
Contract Pharmacy Representative
Davis Brothers Pharmacy
Jeff David, Owner
(304) 564-7249
Signed By Date
7/20/2022
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