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NORTH CAROLINA CVS PHARMACY, L.L.C.
CHC24141-04 MOUNTAIN COMMUNITY HEALTH PARTNERSHIP, INCORPORATED
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Covered Entity Details
Entity Name
MOUNTAIN COMMUNITY HEALTH PARTNERSHIP, INCORPORATED
Subdivision Name
MCHP Dental Center
Type
HRSA-Funded Health Center
340B ID
CHC24141-04
Entity Address
89 N Mitchell Ave
Bakersville, NC 28705-6502
Grant Number
H80CS24141
Participating Start Date
6/5/2023
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07574
12121 S. 226 HWY
SPRUCE PINE, NC 28777
Pharmacy Comments
Contract Details
Approval Date
10/10/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Emily Owens, Pharmacy Director
(828) 688-2104
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/10/2023
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