Contract Pharmacy Details

KENTUCKY CVS PHARMACY, L.L.C.
CHC09959-01 GRACE COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

GRACE COMMUNITY HEALTH CENTER, INC.

Subdivision Name

Grace Health Manchester

Type

HRSA-Funded Health Center

340B ID

CHC09959-01

Entity Address

85 Highway 80
Manchester, KY 40962-1401

Grant Number

H80CS09959

Participating Start Date

10/1/2010

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

KENTUCKY CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06346
409 EAST MAIN STREET
RICHMOND, KY 40475

Pharmacy Comments

Contract Details

Approval Date

4/7/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Michael W Stanley, Chief Executive Officer
(606) 526-9005

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/7/2023

340B Drug Pricing Program Database