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OHIO CVS STORES, L.L.C.
CH050960 COMMUNITY AND RURAL HEALTH SERVICES
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Covered Entity Details
Entity Name
COMMUNITY AND RURAL HEALTH SERVICES
Subdivision Name
Main Site
Type
HRSA-Funded Health Center
340B ID
CH050960
Entity Address
2221 Hayes Avenue
FREMONT, OH 43420
Grant Number
H80CS00661
Participating Start Date
7/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #11049
241 W. MADISON ST.
GIBSONBURG, OH 43431
Pharmacy Comments
Contract Details
Approval Date
7/6/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOSEPH LISZAK, CEO
(419) 334-8943 Ext: 225
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/6/2023
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