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BREWSTER'S HOMETOWN PHARMACY LLC
CH052900 COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
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Covered Entity Details
Entity Name
COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
Subdivision Name
N/A
Type
HRSA-Funded Health Center
340B ID
CH052900
Entity Address
941 MARKET STREET
PIKETON, OH 45661
Grant Number
H80CS00399
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
BREWSTER'S HOMETOWN PHARMACY LLC
Pharmacy Address
104 THORNTON DR
PIKETON, OH 45661
Pharmacy Comments
Contract Details
Approval Date
10/17/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Keith Pitts, President and Chief Executive Officer
(216) 770-3409 Ext: 7009
Contract Pharmacy Representative
Brewsters Hometown Pharmacy LLC
Hope Brewster, PIC/Ownder
(740) 648-3020
Signed By Date
10/17/2022
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