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NORTH CAROLINA CVS PHARMACY, L.L.C.
FQHCLA434C MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
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Covered Entity Details
Entity Name
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
Subdivision Name
MAHEC Newbridge Primary Care Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA434C
Entity Address
218 Elkwood Ave STE 102
Asheville, NC 28804-2212
Grant Number
LALCS45788
Participating Start Date
10/1/2022
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04105
1080 HENDERSONVILLE ROAD
ASHEVILLE, NC 28803
Pharmacy Comments
Contract Details
Approval Date
10/5/2022
Contract Begin Date
11/15/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
OPA Terminated due to audit finding
Contacts
Covered Entity Signing Official
William R Hathaway, CEO
(828) 257-4405
Contract Pharmacy Representative
Wellpartner
Kenneth Bodmer, Vice President
(877) 805-9483
Signed By Date
10/5/2022
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