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NORTH CAROLINA CVS PHARMACY, L.L.C.
CH045800 GOSHEN MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
GOSHEN MEDICAL CENTER, INC.
Subdivision Name
GOSHEN MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH045800
Entity Address
444 SW Center St
Faison, NC 28341
Grant Number
H80CS00181
Participating Start Date
7/1/2003
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07361
1101 S. CROATAN HWY
KILL DEVIL HILLS, NC 27948
Pharmacy Comments
Contract Details
Approval Date
10/23/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/26/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rhonda Barwick, Deputy CEO
(910) 267-1942
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/23/2024
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