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MISSOURI CVS PHARMACY, L.L.C.
CH071496J Regional Health Care Clinic, Inc.
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Covered Entity Details
Entity Name
Regional Health Care Clinic, Inc.
Subdivision Name
Katy Trail Community Health East
Type
HRSA-Funded Health Center
340B ID
CH071496J
Entity Address
305 W Main St
Sedalia, MO 65301-3821
Grant Number
H80CS06668
Participating Start Date
7/1/2022
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 10305
100 EAST BROADWAY BLVD
SEDALIA, MO 65301
Pharmacy Comments
Contract Details
Approval Date
1/15/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Waller, CEO
(208) 800-8676
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2024
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