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PENNSYLVANIA CVS PHARMACY, L.L.C.
CHC00495-12 Union Community Care
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Covered Entity Details
Entity Name
Union Community Care
Subdivision Name
La Academia Charter School-Based Health Center
Type
HRSA-Funded Health Center
340B ID
CHC00495-12
Entity Address
30 N Ann St
Lancaster, PA 17602-3063
Grant Number
H80CS00495
Participating Start Date
7/1/2022
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17569
960 LITITZ PIKE
LITITZ, PA 17543
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alisa Jones, CEO
(717) 945-1551
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/17/2023
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