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GEORGIA CVS PHARMACY, L.L.C.
CH04690H MedCura Health, Inc.
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Covered Entity Details
Entity Name
MedCura Health, Inc.
Subdivision Name
MedCura Rockdale
Type
HRSA-Funded Health Center
340B ID
CH04690H
Entity Address
977 Taylor St SW
Conyers, GA 30012-5357
Grant Number
H80CS00179
Participating Start Date
7/1/2013
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
GEORGIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04595
7550 COVINGTON HWY.
LITHONIA, GA 30058
Pharmacy Comments
Contract Details
Approval Date
1/4/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeff Taylor, Chief Executive Officer
(404) 298-3250
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/4/2024
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