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RHODE ISLAND CVS PHARMACY, L.L.C.
CH012230 WOOD RIVER HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
WOOD RIVER HEALTH SERVICES, INC.
Subdivision Name
WOOD RIVER HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH012230
Entity Address
823 Main St
Hope Valley, RI 02832-1920
Grant Number
H80CS00059
Participating Start Date
10/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RHODE ISLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08320
1187 MAIN ST., PO BOX 58
WYOMING, RI 02898
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHAEL A. LICHTENSTEIN, President & CEO
(401) 387-9648
Contract Pharmacy Representative
CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118
Signed By Date
7/15/2015
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