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NORTH CAROLINA CVS PHARMACY, L.L.C.
FQHCLA434K Mountain Area Health Education Center, INC.
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Covered Entity Details
Entity Name
Mountain Area Health Education Center, INC.
Subdivision Name
Mountain Area Health Education Center, Inc.- MAHEC Dental Health Center at Columbus
Type
Health Center Program Look-Alike
340B ID
FQHCLA434K
Entity Address
130 Forest Glen Rd
Columbus, NC 28722-3456
Grant Number
LALCS45788
Participating Start Date
7/1/2024
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04467
128 CROSS ROAD DR.
MILLS RIVER, NC 28759
Pharmacy Comments
Contract Details
Approval Date
1/2/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William R Hathaway, CEO
(828) 257-4405
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/2/2025
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