340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
GEORGIA CVS PHARMACY, L.L.C.
RRC110074-00 PIEDMONT ATHENS REGIONAL MEDICAL CE
Print
Covered Entity Details
Entity Name
PIEDMONT ATHENS REGIONAL MEDICAL CE
Subdivision Name
Type
Rural Referral Center
340B ID
RRC110074-00
Entity Address
1199 PRINCE AVENUE
ATHENS, GA 30306
Medicare Provider Number
110074
Participating Start Date
12/4/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
GEORGIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03678
196 ALPS RD SUITE #20-B
ATHENS, GA 30606
Pharmacy Comments
Contract Details
Approval Date
10/21/2024
Contract Begin Date
12/9/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/31/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Justin Roberts, CFO
(706) 475-3463
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session