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CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
CH097180 PEACH TREE CLINIC, THE, INC.
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Covered Entity Details
Entity Name
PEACH TREE CLINIC, THE, INC.
Subdivision Name
Peach Tree Clinic, Inc
Type
HRSA-Funded Health Center
340B ID
CH097180
Entity Address
5730 Packard Ave., STE 500
Marysville, CA 95901-7119
Grant Number
H80CS06629
Participating Start Date
1/1/2008
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
Pharmacy Address
DBA CVS/CAREMARK 48067
1780 WALL ST
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
7/3/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Greg Stone, CEO
(530) 741-6245 Ext: 1363
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/3/2024
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