Contract Pharmacy Details

OHIO CVS STORES, L.L.C.
CH05099E HEALTHSOURCE OF OHIO, INC.

Covered Entity Details

Entity Name

HEALTHSOURCE OF OHIO, INC.

Subdivision Name

HealthSource Loveland

Type

HRSA-Funded Health Center

340B ID

CH05099E

Entity Address

6535 Charles Snider Rd
Loveland, OH 45140-9588

Grant Number

H80CS00201

Participating Start Date

10/1/1998

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

OHIO CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03978
1137 STATE ROUTE 131
MILFORD, OH 45150

Pharmacy Comments

Contract Details

Approval Date

7/9/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lisa Jackson, VP of Marketing and Development
(513) 576-7700

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/9/2024

340B Drug Pricing Program Database