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NORTH CAROLINA CVS PHARMACY, L.L.C.
RWII286020 AIDS Leadership Foothills-area Alliance
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Covered Entity Details
Entity Name
AIDS Leadership Foothills-area Alliance
Subdivision Name
Type
Ryan White Part B
340B ID
RWII286020
Entity Address
211 NC-127 S
Hickory, NC 28602
Grant Number
X07HA00051
Participating Start Date
7/1/2021
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03808
2225 12TH AVENUE NE
HICKORY, NC 28601
Pharmacy Comments
Contract Details
Approval Date
10/15/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Iosvany Gispert, Sr. Director of Operations
(828) 322-1447
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2023
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