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CVS PHARMACY, INC.
CH08126D Mountain Family Health Centers
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Covered Entity Details
Entity Name
Mountain Family Health Centers
Subdivision Name
Mountain Family Health Centers Basalt
Type
HRSA-Funded Health Center
340B ID
CH08126D
Entity Address
123 Emma Rd, Ste 106
Basalt, CO 81621-9169
Grant Number
H80CS00830
Participating Start Date
10/1/2011
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
CVS PHARMACY # 17122
110 W MEADOWS DR
GLENWOOD SPRINGS, CO 81601
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Annette M Franta, CFO
(970) 928-1636
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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