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BREWSTER'S HOMETOWN PHARMACY LLC
CH05290P COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
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Covered Entity Details
Entity Name
COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
Subdivision Name
Piketon High School
Type
HRSA-Funded Health Center
340B ID
CH05290P
Entity Address
1414 Piketon Rd
Piketon, OH 45661-9801
Grant Number
H80CS00399
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
BREWSTER'S HOMETOWN PHARMACY LLC
Pharmacy Address
104 THORNTON DR
PIKETON, OH 45661
Pharmacy Comments
Contract Details
Approval Date
4/29/2025
Contract Begin Date
7/1/2025
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
4/13/2025
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