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SOUTH CAROLINA CVS PHARMACY, L.L.C.
CH0416080 LOW COUNTRY HEALTH CARE SYSTEM INC
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Covered Entity Details
Entity Name
LOW COUNTRY HEALTH CARE SYSTEM INC
Subdivision Name
LOW COUNTRY HEALTH CARE SYSTEM
Type
HRSA-Funded Health Center
340B ID
CH0416080
Entity Address
333 REVOLUTIONARY TRAIL
Fairfax, SC 29827-7109
Grant Number
H80CS00092
Participating Start Date
7/1/2000
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03861
705 ELM ST. WEST
HAMPTON, SC 29924
Pharmacy Comments
Contract Details
Approval Date
10/5/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ASHLEY L. BARNES, CEO
(803) 632-2533 Ext: 1125
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/5/2022
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