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GEORGIA CVS PHARMACY, L.L.C.
CH04743B GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
Subdivision Name
GHMS Canton Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH04743B
Entity Address
220 OAKSIDE LN BLDG
CANTON, GA 30114-6413
Grant Number
H80CS00470
Participating Start Date
1/1/2005
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GEORGIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08976
965 JOE FRANK HARRIS PKWY SE
CARTERSVILLE, GA 30120
Pharmacy Comments
Contract Details
Approval Date
4/9/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Todd Shifflet, CEO
(770) 887-1668 Ext: 1102
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/9/2024
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