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OHIO CVS STORES, L.L.C.
CHC26576-00 Dayton Health Center dba Five Rivers Health Centers
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Covered Entity Details
Entity Name
Dayton Health Center dba Five Rivers Health Centers
Subdivision Name
Five Rivers Health Centers Edgemont Campus
Type
HRSA-Funded Health Center
340B ID
CHC26576-00
Entity Address
721 Miami Chapel Road
Dayton, OH 45417
Grant Number
H80CS26576
Participating Start Date
7/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03411
200 E DAYTON YELLOW SPRINGS RD
FAIRBORN, OH 45324
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diane M. Cummins, Chief Operating Officer
(937) 281-5942
Contract Pharmacy Representative
cvs
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
1/15/2018
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