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KENTUCKY CVS PHARMACY, L.L.C.
CHC26637-00 WILLIAMSON HEALTH AND WELLNESS CENTER
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Covered Entity Details
Entity Name
WILLIAMSON HEALTH AND WELLNESS CENTER
Subdivision Name
Williamson Health and Wellness Center
Type
HRSA-Funded Health Center
340B ID
CHC26637-00
Entity Address
184 E. 2nd Avenue, Suite 210
Williamson, WV 25661-3602
Grant Number
H80CS26637
Participating Start Date
1/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
KENTUCKY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06340
197 APPALACHIAN PLAZA
SOUTH WILLIAMSON, KY 41503
Pharmacy Comments
Contract Details
Approval Date
1/16/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Beckett, CEO
(304) 235-3400
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/16/2018
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