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NORTH CAROLINA CVS PHARMACY, L.L.C.
CH04094BD Blue Ridge Community Health Services, Inc.
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Covered Entity Details
Entity Name
Blue Ridge Community Health Services, Inc.
Subdivision Name
Blue Ridge Health - Meridian Bonnie Lane
Type
HRSA-Funded Health Center
340B ID
CH04094BD
Entity Address
44 Bonnie Ln
Sylva, NC 28779-8511
Grant Number
H80CS00650
Participating Start Date
10/1/2022
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07521
773 RUSS AVE.
WAYNESVILLE, NC 28786
Pharmacy Comments
Contract Details
Approval Date
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tammy Greenwell, CHIEF OPERATIONS OFFICER
(828) 233-2288
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/9/2023
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