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PENNSYLVANIA CVS PHARMACY, L.L.C.
CHC00495-04 Union Community Care
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Covered Entity Details
Entity Name
Union Community Care
Subdivision Name
Lebanon Dental
Type
HRSA-Funded Health Center
340B ID
CHC00495-04
Entity Address
101 S 9th St
Lebanon, PA 17042-5108
Grant Number
H80CS00495
Participating Start Date
1/1/2016
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 10045
2239 PERKIOMEN AVE.
READING, PA 19606
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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