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PENNSYLVANIA CVS PHARMACY, L.L.C.
CH03270I KEYSTONE RURAL HEALTH CENTER
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Covered Entity Details
Entity Name
KEYSTONE RURAL HEALTH CENTER
Subdivision Name
Keystone Pediatrics
Type
HRSA-Funded Health Center
340B ID
CH03270I
Entity Address
830 Fifth Avenue STE 103
Chambersburg, PA 17201
Grant Number
H80CS00076
Participating Start Date
4/1/2007
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01642
406 E. MAIN ST.
WAYNESBORO, PA 17268
Pharmacy Comments
Contract Details
Approval Date
10/3/2023
Contract Begin Date
1/1/2024
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
10/3/2023
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