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BREWSTER'S HOMETOWN PHARMACY LLC
CH05290G COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE
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Covered Entity Details
Entity Name
COMMUNITY ACTION COMMITTEE OF PIKE COUNTY, THE
Subdivision Name
PIKETON FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH05290G
Entity Address
7777 US HIGHWAY 23
PIKETON, OH 45661-9102
Grant Number
H80CS00399
Participating Start Date
11/7/2005
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
BREWSTER'S HOMETOWN PHARMACY LLC
Pharmacy Address
104 THORNTON DR
PIKETON, OH 45661
Pharmacy Comments
Contract Details
Approval Date
10/8/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Keith Pitts, President and Chief Executive Officer
(216) 770-3409 Ext: 7009
Contract Pharmacy Representative
Brewsters Hometown Pharmacy LLC
Hope Brewster, PIC/Ownder
(740) 648-3020
Signed By Date
10/8/2024
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