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NORTH CAROLINA CVS PHARMACY, L.L.C.
HV28474 Quality Home Care Services
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Covered Entity Details
Entity Name
Quality Home Care Services
Subdivision Name
Type
Ryan White Part C
340B ID
HV28474
Entity Address
3627 Beatties Ford Road
Charlotte, NC 28216
Grant Number
H76HA28474
Participating Start Date
1/1/2018
Last Recertification Date
2/21/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
NORTH CAROLINA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07056
2115 BEATTIES FORD RD
CHARLOTTE, NC 28216
Pharmacy Comments
Contract Details
Approval Date
4/2/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lisa Wigfall, CEO
(980) 721-1573
Contract Pharmacy Representative
CVS
Jeff Noone, Director
(412) 660-1513
Signed By Date
4/2/2018
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