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RHODE ISLAND CVS PHARMACY, L.L.C.
CH01182N THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
THUNDERMIST WEST WARWICK
Type
HRSA-Funded Health Center
340B ID
CH01182N
Entity Address
186 Providence St
West Warwick, RI 02893
Grant Number
H80CS00454
Participating Start Date
7/1/2007
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
RHODE ISLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02065
11 MAIN ST.
WAKEFIELD, RI 02879
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
2/17/2009
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
8/21/2008
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