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MISSOURI CVS PHARMACY, L.L.C.
CH07043AG Big Springs Medical Association, Inc
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Covered Entity Details
Entity Name
Big Springs Medical Association, Inc
Subdivision Name
Missouri Highlands Hillview School Clinic
Type
HRSA-Funded Health Center
340B ID
CH07043AG
Entity Address
11001 US-160
Harviell, MO 63945
Grant Number
H80CS00703
Participating Start Date
1/1/2023
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 10281
225 NORTH WESTWOOD BLVD.
POPLAR BLUFF, MO 63901
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen R White, CEO
(573) 663-2313 Ext: 3965
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/12/2023
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