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OHIO CVS STORES, L.L.C.
STD403511 Fresh Start Health, PSC
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Covered Entity Details
Entity Name
Fresh Start Health, PSC
Subdivision Name
Morehead, KY Clinic
Type
Sexually Transmitted Diseases
340B ID
STD403511
Entity Address
150 Newtowne Square
Morehead, KY 40351
Grant Number
6NH25PS005135-01-01
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03416
802 11TH ST
PORTSMOUTH, OH 45662
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jerrel Boyer, Medical Director
(606) 923-1124 Ext: 6062258298
Contract Pharmacy Representative
Wellpartner
Michael Petryna, National Sales Executive
(720) 377-7745
Signed By Date
4/15/2025
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