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HIGHLAND PARK CVS, L.L.C.
CAH141320-00 HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. (DBA Paris Community Hospital)
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Covered Entity Details
Entity Name
HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC. (DBA Paris Community Hospital)
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141320-00
Entity Address
721 EAST COURT STREET
PARIS, IL 61944
Medicare Provider Number
141320
Participating Start Date
4/1/2011
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
HIGHLAND PARK CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06694
808 S. MAIN STREET
PARIS, IL 61944
Pharmacy Comments
Contract Details
Approval Date
10/7/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RANDY SIMMONS, CEO
(217) 465-4141 Ext: 218
Contract Pharmacy Representative
CVS Caremark
Anthony Gratto, 340B Vendor Manager
(401) 770-7298
Signed By Date
10/7/2013
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