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ESI MAIL PHARMACY SERVICE
CH052900 COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
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Covered Entity Details
Entity Name
COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
Subdivision Name
N/A
Type
HRSA-Funded Health Center
340B ID
CH052900
Entity Address
941 MARKET STREET
PIKETON, OH 45661
Grant Number
H80CS00399
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/8/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Keith Pitts, President and Chief Executive Officer
(216) 770-3409 Ext: 7009
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
1/16/2024
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