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SOUTH CAROLINA CVS PHARMACY, L.L.C.
STD294053 Lowcountry AIDS Services
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Covered Entity Details
Entity Name
Lowcountry AIDS Services
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD294053
Entity Address
5064 Rivers Ave
North Charleston, SC 29406
Grant Number
5H25PS004378
Participating Start Date
7/1/2017
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03560
1020 ORANGE GROVE ROAD
CHARLESTON, SC 29407
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brad Childs, Executive Director
(843) 747-2273
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/12/2023
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