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SOUTH CAROLINA CVS PHARMACY, L.L.C.
CH04327S EAU CLAIRE COOPERATIVE HEALTH CENTER
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Covered Entity Details
Entity Name
EAU CLAIRE COOPERATIVE HEALTH CENTER
Subdivision Name
Pediatrics of Newberry
Type
HRSA-Funded Health Center
340B ID
CH04327S
Entity Address
2525 Kinard St
Newberry, SC 29108-2909
Grant Number
H80CS00730
Participating Start Date
10/1/2012
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SOUTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03542
1210 WILSON ROAD
NEWBERRY, SC 29108
Pharmacy Comments
Contract Details
Approval Date
10/3/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PEATRA CRUZ, CHIEF ORGANIZATIONAL DEVELOPMENT OFFICER
(803) 733-5969
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/3/2024
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