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PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03270M KEYSTONE RURAL HEALTH CENTER
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Covered Entity Details
Entity Name
KEYSTONE RURAL HEALTH CENTER
Subdivision Name
Keystone Agricultural Worker Program - Berks Co.
Type
HRSA-Funded Health Center
340B ID
CH03270M
Entity Address
1981 State Hill Rd Ste 1
Wyomissing, PA 19610
Grant Number
H80CS00076
Participating Start Date
1/1/2010
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01918
840 WAYNE AVENUE
CHAMBERSBURG, PA 17201
Pharmacy Comments
Contract Details
Approval Date
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/16/2023
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