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GRAND ST. PAUL CVS, L.L.C.
CHC24136-00 UNITED FAMILY PRACTICE HEALTH CENTER
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Covered Entity Details
Entity Name
UNITED FAMILY PRACTICE HEALTH CENTER
Subdivision Name
United Family Medicine
Type
HRSA-Funded Health Center
340B ID
CHC24136-00
Entity Address
1026 7th St W
Saint Paul, MN 55102-3828
Grant Number
H80CS24136
Participating Start Date
4/1/2013
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
GRAND ST. PAUL CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04573
2650 RICE ST.
LITTLE CANADA, MN 55113
Pharmacy Comments
Contract Details
Approval Date
10/9/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lori A Zook, CFO
(651) 206-7294
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/9/2024
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