Contract Pharmacy Details

OHIO CVS STORES, L.L.C.
DSH360003 University of Cincinnati Medical Center LLC

Covered Entity Details

Entity Name

University of Cincinnati Medical Center LLC

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH360003

Entity Address

3188 Bellevue Avenue
CINCINNATI, OH 45219

Medicare Provider Number

360003

Participating Start Date

12/1/1992

Last Recertification Date

8/18/2024

Pharmacy Details

Pharmacy Name

OHIO CVS STORES, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06081
934 E. MCMILLAN ST.
CINCINNATI, OH 45206

Pharmacy Comments

Contract Details

Approval Date

10/24/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/12/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

RICK HINDS, Executive Vice President and Chief Financial Officer
(513) 585-8720

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/24/2016

340B Drug Pricing Program Database