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GEORGIA CVS PHARMACY, L.L.C.
CH045211E FIRST CHOICE PRIMARY CARE, INC.
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Covered Entity Details
Entity Name
FIRST CHOICE PRIMARY CARE, INC.
Subdivision Name
Daybreak Center Suite A
Type
HRSA-Funded Health Center
340B ID
CH045211E
Entity Address
174 Walnut Street
Macon, GA 31201-3440
Grant Number
H80CS08242
Participating Start Date
10/1/2016
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
GEORGIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05631
805 RUSSELL PKWY.
WARNER ROBINS, GA 31088
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Katherine McLeod, CEO
(478) 254-7204
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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