Liberty at Home (HMO SNP) 2019 Pharmacy Directory

Transcription

1 2019 Part D Model Pharmacy Directory Liberty at Home (HMO SNP) 2019 Pharmacy Directory This pharmacy directory was updated on 02/21/2019. For more recent information or other questions, please contact us, Liberty Advantage at Home (HMO SNP) Member Services,(844) or, for TTY users, 711, 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30., or visit LibertyAdvantagePlan.com. Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at LibertyAdvantagePlan.com. May 2018 H6351_2019PharmDirec003_C 1

2 2019 Part D Model Pharmacy Directory Introduction This booklet provides a list of Liberty at Home s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Liberty at Home (HMO SNP) s formulary. We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under Liberty at Home only if they are filled at a network pharmacy [or through our mail order pharmacy service]. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at nonnetwork pharmacies under certain circumstances as described in your Evidence of Coverage. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This list is current as of 02/21/2019. For the most current list, please contact us. Our contact information appears on the front and back cover pages. If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact Liberty at Home. May 2018 H6351_2019PharmDirec003_C 2

3 Retail Pharmacies, including Chain Pharmacies NORTH CAROLINA Alamance Burlington ARMC HEALTH CARE EMPLOYEE 1238 Huffman Mill Rd Burlington, NC (336) ASHER-MCADAMS HEALTHWISE 305 Trollinger St Burlington, NC (336) BURLINGTON CHC 1214 Vaughn Rd Ste 104 Burlington, NC (336) CHARLES DREW COMMUNITY HEALTH CENTER 221 N Graham Hopedale Rd Burlington, NC (336) CVS PHARMACY #02532 * 1149 University Drive Burlington, NC (336) CVS PHARMACY #03853 * 2344 S Church St Burlington, NC (336) CVS PHARMACY #17130 * 1475 University Dr Burlington, NC (336) EDGEWOOD 2213 Edgewood Ave Burlington, NC (336) GLEN RAVEN PHARMACY, INC * 1902 W Webb Avenue Burlington, NC (336) S Church St Burlington, NC (336) MEDICAL VILLAGE APOTHECARY * 1610 Vaughn Rd Burlington, NC (336) MEDICAP 378 Harden Street Burlington, NC (336) RITE AID #11328 * 2127 Chapel Hill Road Burlington, NC (336) RITE AID #11330 * 3465 South Church Street Burlington, NC (336) RITE AID #11331 * 1909 North Church Street Burlington, NC (336) SCOTT COMMUNITY HEALTH CENTER 5270 Union Ridge Rd Burlington, NC (336) TOTAL CARE 2479 S Church St Burlington, NC (336) S Church St Burlington, NC (336) * 3141 Garden Road Burlington, NC (336) * 530 So. Graham-Hopedale Road Burlington, NC (336) Glen Raven CVS PHARMACY #07559 * 2017 W Webb Ave Glen Raven, NC (336) Graham Page 1

4 CVS PHARMACY #04655 * 401 South Main St Graham, NC (336) SOUTH COURT DRUG COMPANY * 210 E Elm St A Graham, NC (336) TARHEEL DRUG * 316 S Main St Graham, NC (336) S Main St Graham, NC (336) Haw River CVS PHARMACY #07515 * 1009 W Main St Haw River, NC (336) HAW RIVER 740 E Main St Haw River, NC (336) Mebane CVS PHARMACY #07053 * 904 South 5th St Mebane, NC (919) Mebane Oaks Rd Mebane, NC (919) * 1318 Mebane Oaks Road Mebane, NC (919) WARREN'S DRUG STORE, INC * 614 N 1st St Mebane, NC (919) Bertie Colerain COLERAIN PRIMARY CARE 109 W River St Colerain, NC (252) Windsor PITTMANS PHARMACY INC * 305 West Granville St Windsor, NC (252) Brunswick Calabash CVS PHARMACY #07420 * 9810 Ocean Hwy Calabash, NC (910) SEASHORE DRUGS * Beach Dr Sw Calabash, NC (910) Leland CVS PHARMACY #05563 * 117 A Village Rd Leland, NC (910) CVS PHARMACY #08928 * 1132 E Cutlar Crossing Leland, NC (910) FAMILY 112-G Village Rd Leland, NC (910) PHARMACY #225 * 2021 Olde Regent Way Leland, NC (910) Grandiflora Dr Leland, NC (910) Village Rd Ne Leland, NC (910) * 1112 Newpoint Blvd Leland, NC (910) Oak Island THOMAS DRUGS * 7917 E Oak Island Dr Oak Island, NC (910) Ocean Isle Beach CVS PHARMACY #07048 * 7295 Beach Drive Ocean Isle Beach, NC (910) Shallotte Page 2

5 CVS PHARMACY #07512 * 4553 Main St Shallotte, NC (910) JUSTICE 301 S Willis Dr Shallotte, NC (910) MINTZ COASTAL DRUG * 4924 Main St Shallotte, NC (910) THOMAS DRUGS * 4750 Main Street Shallotte, NC (910) Main St Shallotte, NC (910) * 4540 Main St Shallotte, NC (910) South Port CVS PHARMACY #07382 * 4961 Long Beach Rd Se Ste 1 South Port, NC (910) Southport GALLOWAY-SANDS PHARMACY #2 * 1513 N Howe St Ste 8 Southport, NC (910) WALGREENS #16170 * 1531 North Howe Street Southport, NC (910) Southport Supply Rd Se Southport, NC (910) * 1675 North Howe Street Southport, NC (910) Sunset Beach 852 Sunset Blvd N Sunset Beach, NC (910) Supply GALLOWAY SANDS 58 Physicians Dr Supply, NC (910) Sabbath Home Rd Sw Supply, NC (910) Chatham Chapel Hill CVS PHARMACY #07321 * Us n Chapel Hill, NC (919) GOVERNORS Governors Dr Chapel Hill, NC (919) Chatham Downs Chapel Hill, NC (919) * Us N Chapel Hill, NC (919) Moncure HAYWOOD MONCURE HEALTH CENTER 7228 Pittsboro-Moncure Rd Moncure, NC (919) Pittsboro PITTSBORO DISCOUNT DRUG * 628 East St Pittsboro, NC (919) WALGREENS #16142 * 321 East St Pittsboro, NC (919) Siler City CVS PHARMACY #04297 * 1506 East 11th St Siler City, NC (919) FOOD LION 109 Food Lion Plaza Siler City, NC (919) Page 3

6 SILER CITY COMMUNITY HEALTH CENTER 224 S 10th Ave Siler City, NC (919) SILER CITY 202a E Raleigh St Siler City, NC (919) E 11th St Siler City, NC (919) * Us Highway 64 W Siler City, NC (919) Columbus Cerro Gordo ELVINGTON DRUG * 7490 Andrew Jackson Hwy Sw Cerro Gordo, NC (910) Chadbourn KOONCE DRUG COMPANY INC * 112 E 7th Ave Chadbourn, NC (910) Delco RIEGELWOOD MUTUAL DRUG * Andrew Jackson Hwy East Delco, NC (910) Lake Waccamaw VILLAGE PRESCRIPTION CENTER * 108 Old E Hwy 74/76 Lake Waccamaw, NC (910) Tabor City DAMERON DISCOUNT DRUGS HEALTH MART * 100 S Main St Tabor City, NC (910) TABOR CITY MEDICINE MART, INC * 220 S Main Street Tabor City, NC (910) East 5th St Tabor City, NC (910) Whiteville BALDWIN WOODS 607 Jefferson St Whiteville, NC (910) CROSSROADS PHARMACY * 20 Whiteville Town Ctr Whiteville, NC (910) CVS PHARMACY #07570 * 902 N J K Powell Blvd Whiteville, NC (910) GUITONS DRUG STORE * 801 S Madison St Whiteville, NC (910) MCNEILLS 620 Jefferson St Whiteville, NC (910) N Jk Powell Blvd Whiteville, NC (910) * 200 Columbus Corners Drive Whiteville, NC (910) Cumberland Eastover EASTOVER DRUG * 3591 Dunn Rd Eastover, NC (910) Fayetteville BORDEAUX DRUG COMPANY INC * 1706 Owen Dr Fayetteville, NC (910) CAPE FEAR DISCOUNT DRUG * Raeford Rd Fayetteville, NC (910) Page 4

7 CAPE FEAR DISCOUNT DRUGS NORTH * 4417 Ramsey St Fayetteville, NC (910) CARLIE C'S PHARMACY #830 * 690 S Reilly Rd Fayetteville, NC (910) CARLIE CS IGA * 600 Cedar Creek Rd Fayetteville, NC (910) CENTER 101 Robeson St Ste 107 Fayetteville, NC (910) CVS PHARMACY #04095 * 3026 Bragg Blvd Fayetteville, NC (910) CVS PHARMACY #04169 * 522 Owen Drive Fayetteville, NC (910) CVS PHARMACY #04293 * 4923 Raeford Rd Fayetteville, NC (910) CVS PHARMACY #04435 * 9539 Cliffdale Rd Fayetteville, NC (910) CVS PHARMACY #05504 * 100 Law Rd Fayetteville, NC (910) CVS PHARMACY #06633 * 7496 Rockfish Rd Fayetteville, NC (910) CVS PHARMACY #07540 * 404 Ramsey St Fayetteville, NC (910) CVS PHARMACY #16231 * 2056 Skibo Rd Fayetteville, NC (910) EXPRESS DISCOUNT PHARMACY LLC * 3613a Raeford Rd Fayetteville, NC (910) Traemoor Dr Fayetteville, NC (910) HEALTH MATTERS 5515 Waldos Beach Rd Fayetteville, NC (910) MASSEY DRUG CO * 1072 Southern Ave Fayetteville, NC (910) MEDICAL ARTS PHARMACY * 1047 Murchison Rd Ste 106 Fayetteville, NC (910) MEDICAP 1431 Ramsey Street Fayetteville, NC (910) PUBLIX PHARMACY #1575 * 3114 Raeford Rd Fayetteville, NC (910) QWIKMED 204 Westwood Shopping Ctr Fayetteville, NC (910) RITE AID #11503 * 2605 Raeford Road Fayetteville, NC (910) RITE AID #11504 * 7860 Raeford Road Fayetteville, NC (910) RITE AID #11506 * 5989 Morganton Road Fayetteville, NC (910) RITE AID #11507 * 3716 Morganton Road Fayetteville, NC (910) SAMS PHARMACY * 1450 Skibo Road Fayetteville, NC (910) Page 5

8 THE MEDICINE SHOPPE 530 Grove St Fayetteville, NC (910) THE PAVILION 6387 Ramsey St Fayetteville, NC (910) VALLEY 1638 Owen Dr Fayetteville, NC (910) VILLAGE 5106 Hwy 87 S Fayetteville, NC (910) Ramsey St Fayetteville, NC (910) Skibo Road Fayetteville, NC (910) Hope Mills Rd Fayetteville, NC (910) Village Dr Fayetteville, NC (910) Grove St Fayetteville, NC (910) Raeford Rd Fayetteville, NC (910) * 1550 Skibo Road Fayetteville, NC (910) * 4601 Ramsey Street Fayetteville, NC (910) * 8660 Cliffdale Rd Fayetteville, NC (479) * 7701 South Raeford Road Fayetteville, NC (910) * 970 Strickland Bridge Rd Fayetteville, NC (910) * 2820 Gillespie St Fayetteville, NC (910) Hope Mills CAPE FEAR DISCOUNT DRUGS - HOPE MILLS * 3018 N Main St Hope Mills, NC (910) CLINIC 3736 S Main Street Hope Mills, NC (910) CVS PHARMACY #03864 * 3100 Legion Rd Hope Mills, NC (910) CVS PHARMACY #07163 * 3966 S Main St Hope Mills, NC (910) * 3030 North Main Hope Mills, NC (910) * 4220 Legion Rd Hope Mills, NC (910) Spring Lake CVS PHARMACY #05587 * 1137 N Bragg Blvd Spring Lake, NC (910) WALGREENS #11693 * 200 N Bragg Blvd Spring Lake, NC (910) Page 6

9 1312 * 670 Lillington Hwy Spring Lake, NC (910) Stedman FOOD LION 5179 Clinton Road Stedman, NC (910) STEDMAN DRUG CENTER * 7445 Clinton Rd Stedman, NC (910) Davie Advance CVS PHARMACY #05379 * 110 Nc Highway 801 N Advance, NC (336) Us Hwy 158 Advance, NC (336) Bermuda Run BERMUDA RUN PHARMACY * 329 Nc Hwy 801 N Bermuda Run, NC (336) THE TOWN 5275 Us Highway 158 Bermuda Run, NC (336) Cooleemee DAVIE DISCOUNT DRUGS * 141 Marginal St Cooleemee, NC (336) Mocksville FOSTER DRUG CO INC * 495 Valley Rd Mocksville, NC (336) Yadkinville Rd Mocksville, NC (336) * 261 Cooper Creek Drive Mocksville, NC (336) Forsyth Clemmons CVS PHARMACY #04253 * 1433 Lewisville Clemmons Rd Clemmons, NC (336) CVS PHARMACY #07026 * 2770 Lewisville Clemmons Rd Clemmons, NC (336) KMART PHARMACY7208 * 2455 Lewisville-Clemmons Rd Pob Clemmons, NC (336) MEDICAL PLAZA- CLEMMONS 2311 Lewisville-Clemmons Rd Clemmons, NC (336) PUBLIX PHARMACY #1574 * 3150 Gammon Ln Clemmons, NC (336) WALGREENS #19937 * 1485 River Ridge Drive Clemmons, NC (336) Lewisville Clemmons Rd Clemmons, NC (336) * 3633 Clemmons Rd Clemmons, NC (336) Kernersville CVS PHARMACY #03643 * 1398 Union Cross Rd. Kernersville, NC (336) CVS PHARMACY #03832 * 1105 S Main St Kernersville, NC (336) CVS PHARMACY #17217 * 1090 S Main St Kernersville, NC (336) GATEWAY PHARMACY LLC * 510 Pineview Dr Kernersville, NC (336) Page 7

10 971 S Main St Kernersville, NC (336) KERNERSVILLE 841 Old Winston Rd Ste 90 Kernersville, NC (336) NOVANT HEALTH 291 Broad St Kernersville, NC (336) N Main St Kernersville, NC (336) * 1130 South Main Street Kernersville, NC (336) * 1035 Beesons Field Dr Kernersville, NC (336) Lewisville LEWISVILLE DRUG COMPANY * 6715 Shallowford Rd Lewisville, NC (336) RITE AID #11314 * 6798 Shallowford Road Lewisville, NC (336) Rural Hall BROAD STREET 8055 Broad St Rural Hall, NC (336) RITE AID #11316 * 995 Bethania Rural Hall Road Rural Hall, NC (336) Walkertown CVS PHARMACY #01218 * 5210 Reidsville Rd Walkertown, NC (336) Main St Walkertown, NC (336) WALKERTOWN FAMILY PHARMACY INC * 2905 Darrow Road Walkertown, NC (336) Winston-Salem 2281 Cloverdale Ave Winston-Salem, NC (336) Winston Salem BAPTIST HOSPITAL SPECIALTY RX * Medical Center Blvd Winston Salem, NC (336) COMPREHENSIVE CANCER CENTER Medical Center Blvd Winston Salem, NC (336) COSTCO 1085 Hanes Mall Blvd Winston Salem, NC (336) CVS PHARMACY #01944 * 606 Coliseum Dr Winston Salem, NC (336) CVS PHARMACY #03504 * 201 West 4th St Winston Salem, NC (336) CVS PHARMACY #03511 * 2221 Cloverdale Ave Winston Salem, NC (336) CVS PHARMACY #03516 * 3325 Robin Hood Rd Winston Salem, NC (336) CVS PHARMACY #03518 * 3592 Yadkinville Rd Winston Salem, NC (336) Page 8

11 CVS PHARMACY #03574 * 3186 Peters Creek Parkway Winston Salem, NC (336) CVS PHARMACY #03812 * 5471 University Pkwy Winston Salem, NC (336) CVS PHARMACY #05595 * 589 N Martin Luther King Jr Dr Winston Salem, NC (336) CVS PHARMACY #07030 * 5001 Country Club Rd Winston Salem, NC (336) CVS PHARMACY #07584 * 855 Hanes Mall Blvd Winston Salem, NC (336) CVS PHARMACY #16457 * 5420 University Pkwy Winston Salem, NC (336) CVS PHARMACY #16465 * 1040 Hanes Mall Blvd Winston Salem, NC (336) DOWNTOWN HEALTH PLAZA 1200 Martin Luther King Jr Dr Winston Salem, NC (336) Grant Hill Ln Winston Salem, NC (336) Reynolda Rd Winston Salem, NC (336) N Peacehaven Rd Winston Salem, NC (336) JONESTOWN 300 Jonestown Road Winston Salem, NC (336) M L K 1489 New Walkertown Rd Winston Salem, NC (336) MARLEY DRUG INC * 5008 Peters Creek Pkwy Winston Salem, NC (336) MEDICAP 1345 N Liberty St Winston Salem, NC (336) MEDICAP 3719 Reynolda Rd Winston Salem, NC (336) NC BAPTIST HOSPITAL Medical Center Blvd Winston Salem, NC (336) NOVANT HEALTH 255 Charlois Blvd Winston Salem, NC (336) NOVANT HEALTH 3333 S Silas Creek Pkwy Winston Salem, NC (336) NOVANT HEALTH 3333 S Silas Creek Pkwy Winston Salem, NC (336) NOVANT HEALTH 100 Robinhood Medical Plz Winston Salem, NC (336) NOVANT HEALTH 105 Vest Mill Circle Winston Salem, NC (336) NOVANT HEALTH 1381 Westgate Center Dr Winston Salem, NC (336) Page 9

12 NOVANT HEALTH SPECIALTY 255 Charlois Blvd Winston Salem, NC (336) NUESTRA FARMACIA LLC * 516 Waughtown St Winston Salem, NC (336) PIEDMONT PLAZA 1920 W 1st St Winston Salem, NC (336) PUBLIX PHARMACY #1475 * 34 Miller St Winston Salem, NC (863) RITE AID #11324 * 2920 Waughtown Street Winston Salem, NC (336) ROBINHOOD FAMILY PHARMACY LLC * 3443 Robinhood Rd Ste S Winston Salem, NC (336) SAMS PHARMACY * 284 Summit Square Blvd Winston Salem, NC (336) SAMS PHARMACY * 930 Hanes Mall Blvd Winston Salem, NC (336) SOUTH PARK FAMILY 1215 A West Clemmonsville Rd Winston Salem, NC (336) SOUTHSIDE DISCOUNT 3085 Waughtown St Winston Salem, NC (336) STANLEYVILLE FAMILY 475 Summit Square Blvd Winston Salem, NC (336) TRIAD CHOICE PHARMACY LLC * 658 Waughtown St Winston Salem, NC (336) Reynolda Rd Winston Salem, NC (336) Country Club Rd Winston Salem, NC (336) Cloverdale Ave Winston Salem, NC (336) Robinhood Rd Winston Salem, NC (336) University Pkwy Winston Salem, NC (336) S Stratford Rd Winston Salem, NC (336) Meadowlark Dr Winston Salem, NC (336) * 320 East Hanes Mill Road Winston Salem, NC (336) * 4550 Kester Mill Road Winston Salem, NC (336) * 3475 Parkway Village Cir Winston Salem, NC (336) * 5039 University Pkwy Winston Salem, NC (336) * 180 Harvey St Winston Salem, NC (336) Page 10

13 6814 * 5175 Brookberry Park Ave Winston Salem, NC (336) WSSU WELLNESS CENTER 601 S. Martin Luther King Jr. Dr., Suite 244 Winston Salem, NC (336) Halifax Enfield DRUGCARE 132 Whitfield St Enfield, NC (252) Hollister RHG 204 Evans Rd Hollister, NC (252) Littleton FUTRELL PHARMACY OF LITTLETON * 123 E South Main St Littleton, NC (252) Roanoke Rapids CVS PHARMACY #03387 * 1124 E. 10th St. Roanoke Rapids, NC (252) DRUGCO DISCOUNT 107 Smith Church Rd Roanoke Rapids, NC (252) DRUGCO EXPRESS * 1096 E 10th St Roanoke Rapids, NC (252) SPEARS 405 Becker Dr Roanoke Rapids, NC (252) Smith Church Rd Roanoke Rapids, NC (252) * 251 Premier Blvd Roanoke Rapids, NC (252) Scotland Neck MCDOWELLS 1004 Main St Scotland Neck, NC (252) Johnston Benson CARLIE C'S PHARMACY #870 * 604 S Wall Street Benson, NC (919) CVS PHARMACY #00427 * Nc 210 Hwy Benson, NC (919) DAVIS DRUG COMPANY * Nc Hwy 210 Benson, NC (919) EASTERN CAROLINA MEDICAL CENTER * 1 Medical Dr Benson, NC (919) HEALTHSMART PHARMACY * 70 Crape Myrtle Drive Benson, NC (919) WALGREENS #16156 * 403 E Main St Benson, NC (919) WARREN DRUG COMPANY * 209 E Main Street Benson, NC (919) WOOD PHARMACY INC 1302 N Johnson St Benson, NC (919) Clayton BEDDINGFIELD DRUGS LLC * 95 Springbrook Avenue Clayton, NC (919) CLAYTON Us 70 Hwy Business West Clayton, NC (919) CVS PHARMACY #02771 * Us 70 West Clayton, NC (919) Page 11

14 CVS PHARMACY #10481 * 32 Village Center Dr Clayton, NC (919) FOOD LION 50 Neuse River Parkway Clayton, NC (919) Flowers Crossroads Way Clayton, NC (919) HEALTHSMART PHARMACY * 9197 Cleveland Rd Clayton, NC (919) REALO DISCOUNT DRUGS * 322 Pritchard Rd Clayton, NC (919) Us Highway 70 W Clayton, NC (919) * 805 Town Centre Blvd Clayton, NC (919) Four Oaks PARKER 5829 Us Highway 301 S Four Oaks, NC (919) REALO DISCOUNT DRUGS * 6030 Us Highway 301 S Four Oaks, NC (919) Garner CVS PHARMACY #03214 * 5680 Nc 42 Hwy West Garner, NC (919) HEALTHSMART PHARMACY * 127 Mast Drive Garner, NC (919) Cleveland Rd. Garner, NC (919) * 5141 Nc Hwy 42 Garner, NC (919) Kenly DAVIS DRUG COMPANY * 103 W 2nd St Kenly, NC (919) KENLY DRUG & PHARMACY INC * 104 E 2nd St Kenly, NC (919) Princeton WOODARD DRUG STORE INC * 102 Edwards Street Princeton, NC (919) Selma CREECH DRUG COMPANY * 126 N Raiford St Selma, NC (919) Smithfield CARROLL 840 S Brightleaf Blvd Smithfield, NC (919) CVS PHARMACY #07580 * 1180 N Bright Leaf Blvd Smithfield, NC (919) JOHNSTON HEALTH OUTPATIENT 509 N Brightleaf Blvd Smithfield, NC (919) REALO DISCOUNT DRUG STORES INC * 601 North 8th Street Smithfield, NC (919) N Brightleaf Blvd Smithfield, NC (919) * 1299 North Brightleaf Smithfield, NC (919) Page 12

15 Lee Sanford CVS PHARMACY #05384 * 133 Marketplace Dr Sanford, NC (919) CVS PHARMACY #07329 * 1802 South Horner Blvd Sanford, NC (919) HOME TOWN 101 S Vance St Sanford, NC (919) MEDICINE PARK 100 Park Ave Sanford, NC (919) RITE AID #11342 * 1131 Spring Lane Sanford, NC (919) SANFORD 1720 S Horner Blvd Sanford, NC (919) WALGREENS #16149 * 1050 S Horner Blvd Sanford, NC (919) Jefferson Davis Hwy Sanford, NC (919) S Horner Blvd Sanford, NC (919) * 3310 Nc Highway 87 S Sanford, NC (919) New Hanover Carolina Beach CVS PHARMACY #07345 * 901 Dow Rd Carolina Beach, NC (910) Lake Park Blvd N Carolina Beach, NC (910) Castle Hayne CVS PHARMACY #07350 * 5712 Castle Hayne Rd Castle Hayne, NC (910) Wilmington CAPE FEAR 5235 South College Road Wilmington, NC (910) COSTCO 5351 Gingerwood Dr Wilmington, NC (910) CVS PHARMACY #03594 * 2607 Carolina Beach Rd Wilmington, NC (910) CVS PHARMACY #03816 * 4600 Oleander Drive Wilmington, NC (910) CVS PHARMACY #03822 * 1712 Eastwood Rd Wilmington, NC (910) CVS PHARMACY #03836 * 2302 S 17th St Wilmington, NC (910) CVS PHARMACY #04298 * 6435 Carolina Beach Rd Wilmington, NC (910) CVS PHARMACY #04622 * 3625 South College Rd Wilmington, NC (910) CVS PHARMACY #04846 * 3302 Market St. (Sec) Wilmington, NC (910) CVS PHARMACY #05557 * 6901 Market St Wilmington, NC (910) CVS PHARMACY #05760 * 1929 Oleander Drive Wilmington, NC (910) CVS PHARMACY #16480 * 4711 New Centre Dr Wilmington, NC (910) Page 13

16 5920 Carolina Beach Rd Wilmington, NC (910) S College Rd Wilmington, NC (910) Market Street Wilmington, NC (910) Parker Farm Rd Wilmington, NC (910) KING'S PHARMACY & COMPOUNDING LAB * 2231 S College Rd Wilmington, NC (910) MARKET STREET 1612 Market Street Wilmington, NC (910) MEDNORTH HEALTH CENTER 925 N 4th St Wilmington, NC (910) NHRMC ED NORTH 151 Scotts Hill Medical Dr Wilmington, NC (910) NHRMC OUTPATIENT/EMPLOYEE 2131 S 17th St Wilmington, NC (910) PUBLIX PHARMACY #1516 * 716 Bragg Dr Wilmington, NC (910) PUBLIX PHARMACY #1580 * 7144 Market St Wilmington, NC (910) RITE AID #11519 * 1618 Dawson Street Wilmington, NC (910) RITE AID #11522 * 3501 Oleander Drive Wilmington, NC (910) RITE AID #11524 * 2401 College Road North Wilmington, NC (910) SAMS PHARMACY * 412 S College Road Wilmington, NC (910) SEASHORE DRUGS INC * 2059 Carolina Beach Rd Wilmington, NC (910) b Castle Hayne Rd Cape Fear Plaza Wilmington, NC (910) Market St Wilmington, NC (910) Market St Wilmington, NC (910) Market St Wilmington, NC (910) Oleander Dr Wilmington, NC (910) Carolina Beach Rd Wilmington, NC (910) S 17th St Wilmington, NC (910) S College Rd Wilmington, NC (910) Page 14

17 1348 * 5135 Carolina Beach Road Wilmington, NC (910) * 5226 Sigmon Road Wilmington, NC (910) * 8035 Market St Wilmington, NC (910) WINTER PARK DRUG STORE INC * 5220 Wrightsville Ave Wilmington, NC (910) Orange Carrboro CARRBORO FAMILY 104 Hwy 54 W Bypass Unit J Carrboro, NC (919) CHAPEL HILL CARRBORO HEALTH CENTER 301 Lloyd St Carrboro, NC (919) CVS PHARMACY #03833 * 200 N Greensboro St Carrboro, NC (919) RITE AID #11358 * 602 G Jones Ferry Road Carrboro, NC (919) TARHEEL TOWN 370 E Main Street Carrboro, NC (919) Chapel Hill Chapelton Ct Ste 300 Chapel Hill, NC (984) CAMPUS HEALTH Cb 7470 James A Taylor Bldg Rm 3 Chapel Hill, NC (919) CVS PHARMACY #03898 * 1724 Chapel Hill Durham Blvd Chapel Hill, NC (919) CVS PHARMACY #10277 * 137 E Franklin St Chapel Hill, NC (919) CVS PHARMACY #17702 * 143 W Franklin St Ste 120 Chapel Hill, NC (919) S Estes Drive Chapel Hill, NC (919) Martin Luther King Jr Blvd Chapel Hill, NC (919) W Barbee Chapel Rd Chapel Hill, NC (919) SOUTHERN VILLAGE 300 Market Street Chapel Hill, NC (919) STUDENT STORES 207 South Rd Chapel Hill, NC (919) UNC HOSPITALS AMBULATORY CARE CENTER 102 Mason Farm Rd Chapel Hill, NC (984) UNC HOSPITALS CENTRAL OUTPATIENT 101 Manning Dr Chapel Hill, NC (984) UNC HOSPITALS EMPLOYEE 101 Manning Dr Chapel Hill, NC (984) Page 15

18 1500 E Franklin St Chapel Hill, NC (919) E Franklin St Chapel Hill, NC (919) Environ Way Chapel Hill, NC (919) Martin Luther King Jr Blvd Chapel Hill, NC (919) Hillsborough CAROLINA BEHAVIORAL CARE 209 Millstone Dr Ste A Hillsborough, NC (919) HILLSBOROUGH PHARMACY & NUTRITION * 110 Boone Square St Ste 29 Hillsborough, NC (919) LLOYDS 118 W King St Hillsborough, NC (919) UNC HILLSBOROUGH OUTPATIENT 430 Waterstone Dr Hillsborough, NC (984) WALGREENS #16128 * 200 Hwy 70 East Hillsborough, NC (919) * 501 Hampton Pointe Blvd Hillsborough, NC (919) Rowan China Grove CHINA GROVE DRUG COMPANY * 112 S Main St China Grove, NC (704) FOOD LION 1460 Main Street China Grove, NC (704) PRICE 422 N Hwy 29 China Grove, NC (704) RITE AID #11433 * 508 Highway 29 North China Grove, NC (704) Cleveland CLEVELAND DRUG CO INC * 11745b Statesville Blvd Cleveland, NC (704) Granite Quarry PRICE 110 East Bank St Granite Quarry, NC (704) Kannapolis CANNON PHARMACY NORTH * 1402 N Cannon Blvd Kannapolis, NC (704) MOOSE PHARMACY OF KANNAPOLIS * 1113 N Main St Kannapolis, NC (704) Rockwell COUNTRY PHARMACY INC * 610 W Main St Ste A Rockwell, NC (704) CRESCENT 314 E Main St Rockwell, NC (704) CVS PHARMACY #07566 * 8765 Hwy 52 Rockwell, NC (704) Salisbury AVITA 1431 W Innes St Salisbury, NC (800) CVS PHARMACY #03592 * 1702 East Innes St Salisbury, NC (704) Page 16

19 CVS PHARMACY #07539 * 1924 Statesville Blvd Salisbury, NC (704) FOOD LION 525 Jake Alexander Blvd W Salisbury, NC (704) MOOSE PHARMACY OF SALISBURY * 1408 West Innes Street Salisbury, NC (704) NOVANT HEALTH 911 W Henderson St Salisbury, NC (704) THE MEDICINE SHOPPE 1357 W Innes St Salisbury, NC (704) Jake Alexander Blvd W Salisbury, NC (704) W Innes St Salisbury, NC (704) E Innes St Salisbury, NC (704) * 323 So. Arlington St. Salisbury, NC (704) Sampson Clinton CLINTON DRUG COMPANY * 307 Beaman Street Clinton, NC (910) CVS PHARMACY #07314 * 507 College St Clinton, NC (910) MATTHEWS HEALTHMART DRUGS * 408 Northeast Blvd Clinton, NC (910) College St Clinton, NC (910) * 1415 Sunset Avenue Clinton, NC (910) Newton Grove NEWTON GROVE DRUG CO INC * 305 Weeks Circle Newton Grove, NC (910) Roseboro 218 W Martin Luther King Blvd Roseboro, NC (910) Warren Littleton DRUGCO DISCOUNT 139 Elams Rd Littleton, NC (252) Norlina RHG 110 Division Street Norlina, NC (252) Warrenton FUTRELL PHARMACY OF WARRENTON * 108 B S Main St Warrenton, NC (252) E Macon St Warrenton, NC (252) Home Infusion Pharmacies ALABAMA Mobile Mobile HPC SPECIALTY 63 S Royal St Mobile, AL (800) CALIFORNIA Los Angeles Page 17

20 Santa Fe Springs CRESCENT HEALTHCARE INC Telegraph Rd Santa Fe Springs, CA (562) Riverside Temecula NUFACTOR Winchester Rd Temecula, CA (800) FLORIDA Broward Pompano Beach PATIENT CARE AMERICA 3890 Park Central Blvd N. Pompano Beach, FL (866) GEORGIA Dawson Dawsonville INTOUCH PHARMACY 75 Elliott Rd Ste 200 Dawsonville, GA (706) Dekalb Clarkston OPTION CARE 808 Park North Blvd Clarkston, GA (404) ILLINOIS Cook Chicago PHARMASCRIPT INC N. Broadway Avenue Chicago, IL (773) Mt Prospect CORAM CVS/SPECIALTY INFUSION SERVICES 1471 Bus Center Dr Mt Prospect, IL (847) Orland Park AMERICAN SERVICE AND PRODUCT th St Orland Park, IL (708) LOUISIANA Jefferson Metairie FAST ACCESS SPECIALTY THERAPEUTICS 3131 N I 10 Service Rd E Ste 202 Metairie, LA (877) St. John The Baptist Reserve GEM DRUGS * 139 Central Ave Reserve, LA (985) MASSACHUSETTS Middlesex Woburn DIPLOMAT SPECIALTY INFUSION GROUP 20 Commerce Way Ste 2 Woburn, MA (781) Worcester Shrewsbury KABAFUSION, INC. 159 Memorial Dr Ste E Shrewsbury, MA (888) MICHIGAN Kalamazoo Kalamazoo OPTIMED SPECIALTY PHARMACY 6480 Technology Kalamazoo, MI (877) Oakland Troy HOMESCRIPTS 500 Kirts Blvd Ste 300 Troy, MI (248) MINNESOTA Dakota Mendota Heights CORAM CVS/SPECIALTY INFUSION SERVICES 2345 Waters Dr Mendota Heights, MN (651) MISSOURI Jackson Lees Summit HERITAGE BIOLOGICS, INC. 255 Nw Victoria Dr Lees Summit, MO (855) NEW JERSEY Monmouth Howell Page 18

21 PARKWAY PHARMACY LP 3502 Us Highway 9 Howell, NJ (866) Passaic Totowa BIOLOGICTX LLC 40d Commerce Way Totowa, NJ (877) Wayne BASIC HOME INFUSION 1401 Valley Road Wayne, NJ (888) NORTH CAROLINA Buncombe Asheville CORAM CVS/SPECIALTY INFUSION SERVICES 30 Garfield St Asheville, NC (800) Cumberland Fayetteville BIOSCRIP INFUSION SERVICES 1738 Owen Drive, Suite 101 Fayetteville, NC (910) Durham Durham UNC HOMECARE SPECIALISTS 4400 Emperor Blvd Durham, NC (984) Guilford Greensboro ACCREDO HEALTH GROUP INC 422 Gallimore Dairy Rd Ste A Greensboro, NC (336) DIPLOMAT SPECIALTY INFUSION GROUP 311 Pomona Drive Greensboro, NC (336) Kernersville NUFACTOR 1601 Old Greensboro Rd Kernersville, NC (844) Iredell Statesville FAMILY PHARMACY OF STATESVILLE * 208 Old Mocksville Rd Statesville, NC (704) Mecklenburg Charlotte BIOSCRIP INFUSION SERVICES 2201 Crownpoint Executive Dr Ste C Charlotte, NC (707) CORAM CVS/SPECIALTY INFUSION SERVICES 9401 Southern Pine Blvd Charlotte, NC (704) US BIOSERVICES 5031 W W T Harris Blvd Ste 5031-H Charlotte, NC (800) New Hanover Wilmington OPTION CARE 131 Racine Dr Ste 100b Wilmington, NC (910) Wake Morrisville CORAM CVS/SPECIALTY INFUSION SERVICES 507 Airport Blvd Morrisville, NC (919) OPTION CARE 1015 Aviation Pkwy Ste 700 Morrisville, NC (919) Raleigh ACARIAHEALTH PHARMACY, INC Acc Blvd Ste 103 Raleigh, NC (800) DIPLOMAT SPECIALTY INFUSION GROUP 140 Northway Court Raleigh, NC (888) OHIO Hamilton Cincinnati Page 19

22 DIPLOMAT SPECIALTY INFUSION GROUP 7167 E Kemper Rd Cincinnati, OH (513) PENNSYLVANIA Delaware Boothwyn PENTEC HEALTH, INC 4 Creek Parkway Boothwyn, PA (800) Garnet Valley ELWYN SPECIALTY CARE 3070 Mccann Farm Dr Ste 101 Garnet Valley, PA (610) Sharon Hill HOMETECH ADVANCED THERAPIES, INC. * 505 Elmwood Ave Sharon Hill, PA (484) SOUTH CAROLINA Richland Columbia CORAM HEALTHCARE/CAROLINA HOME THERAPEUTICS 720 Gracern Rd Columbia, SC (803) TENNESSEE Shelby Memphis HPC SPECIALTY 6423 Shelby View Dr Ste 104 Memphis, TN (901) Washington Johnson City MOUNTAIN STATES PHARMACY AT JOHNSON CITY * 523 N State Of Franklin Rd Johnson City, TN (423) TEXAS Collin Frisco US BIOSERVICES 3200 Internet Blvd Frisco, TX (888) Dallas Dallas PARAGON INFUSION CARE, INC Preston Road Dallas, TX (972) Irving Y MEDICAL ASSOCIATES, INC N Mac Arthur Blvd Irving, TX (972) Denton Lewisville PHARMACY SPECIALISTS 697 S Stemmons Fwy Lewisville, TX (972) Harris Houston ACARIAHEALTH PHARMACY # W Sam Houston Pkwy N # 130 Houston, TX (800) SPECIALTY THERAPEUTIC CARE, LP 1311 W Sam Houston Pkwy N Ste 150 Houston, TX (866) Lubbock Lubbock IV SOLUTIONS OF LUBBOCK rd Street Lubbock, TX (806) Tarrant Ft Worth AMERICAN OUTCOMES MGMT LP 6310 Southwest Blvd Ste 204 Ft Worth, TX (800) VIRGINIA Danville City Danville PIEDMONT INFUSION SERVICES, INC 111 Mall Drive Danville, VA (434) Page 20

23 Long-Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under Liberty Advantage through the facility s long-term care pharmacy or another network long-term care pharmacy. CALIFORNIA Orange Santa Ana LIFETIME VALUE 301 East 17th Street Santa Ana, CA (714) COLORADO Boulder Boulder CAREKINESIS, INC Spine Rd Ste 100 Boulder, CO (888) GEORGIA Gwinnett Norcross ALIXARX - GA HUB 3100 Northwoods Pl Ste F Norcross, GA (855) MICHIGAN Kalamazoo Kalamazoo OPTIMED SPECIALTY PHARMACY 6480 Technology Kalamazoo, MI (877) NEW JERSEY Burlington Moorestown CAREKINESIS INC 228 Strawbridge Dr Moorestown, NJ (888) Middlesex Old Bridge THE WELLNESS CENTER PHARMACY & SURGICAL * 3117 Us Highway 9 Old Bridge, NJ (732) NEW YORK Kings Brooklyn MEDPACK 5923 Strickland Ave Brooklyn, NY (347) NORTH CAROLINA Alamance Burlington GENOA HEALTHCARE, LLC 2732 Ann Elizabeth Dr Burlington, NC (336) PHARMACARE SERVICES INC 509 S Lexington Ave Burlington, NC (336) Graham TAR HEEL DRUG LTC, LLC 316 S Main St Graham, NC (336) Beaufort Washington EXPRESS CARE PHARMACY 505 Hackney Ave Washington, NC (866) Buncombe Arden SELECT CARE PHARMACY 15 Glenn Bridge Rd Ste A Arden, NC (828) Asheville BLUE RIDGE PHARMACY INC Tunnel Rd Asheville, NC (828) GENOA HEALTHCARE, LLC 119 Tunnel Rd Ste G Asheville, NC (828) GENOA HEALTHCARE, LLC 1314 Patton Ave Ste E Asheville, NC (828) Fairview AMERICARE PHARMACY CONSULTANTS 1185 Charlotte Hwy Ste M Fairview, NC (828) Fletcher Page 21

24 CANE CREEK PHARMACY, INC 785 Cane Creek Rd Fletcher, NC (828) Swannanoa PSA CLINIC 2294 Us Highway 70 Swannanoa, NC (828) PSA PHARMACY 2294 And 1/2 Us Highway 70 Swannanoa, NC (828) Burke Valdese BLUE RIDGE LONG TERM CARE PHARMACY 298 Perkins Rd Valdese, NC (828) Cabarrus Concord CANNON PHARMACY ENHANCED CARE 140 Cabarrus Ave W Concord, NC (704) Harrisburg HARRISBURGS HOMETOWN 5006 Hwy 49 South Harrisburg, NC (704) Caldwell Lenoir THE SCRIPT PHARMACY 1450 Shaire Center Dr Lenoir, NC (828) Carteret Sea Level SEALEVEL 440 Highway 70 E Sea Level, NC (252) Catawba Conover MEDICAL VILLAGE PHARMACY 815 Fairgrove Church Rd Se Conover, NC (828) Hickory OMNICARE OF HICKORY th St Pl Se Hickory, NC (828) TRIDENTCARERX 910 Tate Blvd Se Ste 111 Hickory, NC (828) Cherokee Murphy KING'S 30 Peachtree St Murphy, NC (828) Clay Hayesville KING'S PHARMACY HAYESVILLE * 16 Wayne Brooks Ln Hayesville, NC (828) Cleveland Fallston FALLSTON PHARMACY INC * 5011 Fallston Rd Fallston, NC (704) Columbus Tabor City MEDICINE MART LONG TERM CARE 214 S Main St Tabor City, NC (910) Whiteville MCNEILLS LONG TERM CARE PHARMACY 712 Tram Rd Whiteville, NC (910) Craven New Bern GENOA HEALTHCARE, LLC 1309 Tatum Drive, Suite 1 New Bern, NC (252) PHARMACY PLUS OF NEW BERN * 1204 D South Glenburnie Rd New Bern, NC (252) Page 22

25 REALO DISCOUNT DRUGS * 1301 Commerce Dr New Bern, NC (252) REALO EXTENDED CARE PHARMACY 2129 S Glenburnie Rd New Bern, NC (252) Cumberland Fayetteville MEDICAP 1431 Ramsey Street Fayetteville, NC (910) Davidson Denton YADKIN VALLEY HEALTHCARE LLC Hwy 109 South Denton, NC (336) Durham Durham ASPIRAR PHARMACY OF DURHAM, LLC 4411 Ben Franklin Blvd Durham, NC (919) HILLCREST CONVALESCENT CENTER INC 1417 W Pettigrew St Durham, NC (919) PRUITTHEALTH PHARMACY SERVICES - DURHAM 4022 Stirrup Creek Dr Durham, NC (800) UNC SHARED SERVICES CENTER PHARMACY, A DEPARTMENT OF UNC HEA * 4400 Emperor Blvd Durham, NC (919) Edgecombe Tarboro THORNE DRUG COMPANY * 2900 N Main St Tarboro, NC (252) Forsyth Kernersville PEAK PHARMACY 841 Old Winston Rd Ste 93 Kernersville, NC (336) SOUTHERN PHARMACY SERVICES WINSTON- SALEM 1031 E Mountain St Bldg 319 Kernersville, NC (866) Winston-Salem MEDIPACK PHARMACY LLC 3917 Westpoint Blvd Winston-Salem, NC (336) Winston Salem GENOA HEALTHCARE, LLC 4140 Cherry St Winston Salem, NC (336) HOLLADAY HEALTHCARE 2560 Landmark Dr Winston Salem, NC (800) TRIAD CHOICE PHARMACY LLC 658 Waughtown St Winston Salem, NC (336) Gaston Cherryville MEDICAL CENTER 607 E Academy St Cherryville, NC (704) Guilford Greensboro GENOA HEALTHCARE, LLC 201 N. Eugene St. Greensboro, NC (336) PHARMERICA 3400 West Wendover Ave Greensboro, NC (336) WHITESTONE PHARMACY 700 S Holden Rd Greensboro, NC (336) Halifax Scotland Neck Page 23

26 MCDOWELLS 1004 Main St Scotland Neck, NC (252) Harnett Lillington CAPE FEAR LONG TERM CARE PHARMACY LLC 185 Pine State St Lillington, NC (910) Iredell Mooresville HEALTHSMART PHARMACY (EAST) * 594 N Main St Mooresville, NC (704) NEIL MEDICAL GROUP 947 N Main St Mooresville, NC (800) Statesville FAMILY PHARMACY OF STATESVILLE * 208 Old Mocksville Rd Statesville, NC (704) Lee Sanford MEDICINE PARK 100 Park Ave Sanford, NC (919) Lenoir Kinston NEIL MEDICAL GROUP 2545 Jetport Rd Kinston, NC (800) Pink Hill SOUTHERN PHARMACY SERVICES 4459 Tar Heel Drive Pink Hill, NC (866) Mecklenburg Charlotte CMC AIRPORT CENTER PHARMACY 4400 Golf Acres Dr Charlotte, NC (704) GENOA HEALTHCARE, LLC 5700 Executive Center Dr Ste 216 Charlotte, NC (704) LONG'S DRUGS * 3039 South Blvd Ste F Charlotte, NC (704) OMNICARE OF CHARLOTTE 6601 North Park Blvd. Unit C Charlotte, NC (919) PHARMERICA 4600 Lebanon Road Charlotte, NC (704) REMEDI SENIORCARE OF CHARLOTTE 7504 E Independence Blvd Suite 112 Charlotte, NC (844) SENIOR CARE PHARMACY 4455 Morris Park Dr Charlotte, NC (704) Matthews COPPER CREEK PHARMACY 1207 Crews Rd Ste D Matthews, NC (704) New Hanover Wilmington PHARMACY INNOVATIONS 3608 Oleander Dr Ste E Wilmington, NC (910) Onslow Jacksonville NORTHWOODS DRUG COMPANY INC * 344 Henderson Dr Jacksonville, NC (910) Orange Hillsborough CAROLINA BEHAVIORAL CARE PHARMACY 209 Millstone Dr Hillsborough, NC (919) Perquimans Hertford Page 24

27 WOODARDS 101 N Church Street Hertford, NC (252) Pitt Greenville GENOA HEALTHCARE, LLC 2602 Courtier Drive, Ste 2200 Greenville, NC (252) HOMETOWN DISCOUNT PHARMACY OF GREENVILLE * 1631 S E Greenville Blvd Greenville, NC (252) Simpson PHARMERICA 749 A Simpson Street Simpson, NC (252) Polk Columbus FOOTHILLS 80 Shuford Rd Columbus, NC (828) Randolph Asheboro CENTRAL CAROLINA PHARMACEUTICAL SERVICES 308 White Oak St Asheboro, NC (336) Robeson Lumberton WOODHAVEN PHARMACY 1150 Pine Run Dr Lumberton, NC (910) Rockingham Eden LAYNECARE, LLC. 509 S Van Buren Rd Eden, NC (336) Reidsville RXCARE INC 219 Gilmer St Reidsville, NC (336) Rowan Salisbury LSA PHARMACY INC 320 Calhoun St Salisbury, NC (704) MOOSE PHARMACY OF SALISBURY * 1408 West Innes Street Salisbury, NC (704) Rutherford Forest City SMITHS DRUG OF FOREST CITY INC * 139 E Main St Forest City, NC (828) Spindale SPINDALE LONG TERM CARE PHARMACY INC 117 W Main St Spindale, NC (828) Vance Henderson MAST LONG TERM CARE 1910 Ross Mill Rd Henderson, NC (252) Wake Cary BLUE RIDGE PHARMACY 175 Towerview Ct Cary, NC (828) PHYSICIANS PHARMACY ALLIANCE 118 Mackenan Dr Ste 200 Cary, NC (866) Raleigh HEALTH PARK PHARMACY * 8300 Health Park Raleigh, NC (919) HOLLY PARK 3058 Wake Forest Rd Raleigh, NC (919) KERR HEALTH LONG TERM CARE, LLC 8431 Garvey Dr Raleigh, NC (919) Page 25

28 OMNICARE OF RALEIGH 1815 Garner Station Blvd Raleigh, NC (919) Watauga Blowing Rock VILLAGE 625 Chestnut Ridge Parkway Blowing Rock, NC (828) Boone BOONE DRUG AND HEALTH CARE * 345 Deerfield Rd Boone, NC (828) Wayne Goldsboro RAPER DRUGS INC * 2303 Wayne Memorial Drive Goldsboro, NC (919) Wilson Wilson LONGLEAF NEURO MEDICAL TREATMENT CENTER 4761 Ward Blvd Wilson, NC (252) PENNSYLVANIA Butler Warrendale PHARMBLUE LLC * 40 Pennwood Pl Ste 300 Warrendale, PA (724) RX BLUE STAR SOLUTIONS LLC * 40 Pennwood Pl Ste 200 Warrendale, PA (412) Delaware Garnet Valley ELWYN SPECIALTY CARE 3070 Mccann Farm Dr Ste 101 Garnet Valley, PA (610) SOUTH CAROLINA Chesterfield Chesterfield CHESTERFIELD DRUG COMPANY * 129 Main St Chesterfield, SC (843) Spartanburg Spartanburg WHITE OAK PHARMACY 1233 Boiling Springs Rd Spartanburg, SC (864) TENNESSEE Blount Maryville BLOUNT SPECIALTY PHARMACY 131 Montgomery Lane Maryville, TN (865) Davidson Nashville PCA NUSCRIPTRX 5215 Linbar Drive Nashville, TN (866) Putnam Cookeville PEGASUS EXPRESS PHARMACY 621 E 15th St Cookeville, TN (931) Rutherford Murfreesboro TWELVESTONE PHARMACY, LLC 352 W Northfield Blvd Ste 3b Murfreesboro, TN (615) Washington Johnson City PHARMACY NETWORK SERVICES 527 N. State Of Franklin Rd Johnson City, TN (423) VIRGINIA Hanover Ashland REMEDI SENIORCARE Lakeridge Pkwy Ashland, VA (804) Richmond City Richmond WESTWOOD PHARMACY CLINICAL SERVICES 5823 Patterson Ave Richmond, VA (804) Page 26

29 Virginia Beach City Virginia Beach SENTARA RX 800 Independence Blvd Ste 100 Virginia Beach, VA (757) LUMICERA HEALTH SERVICES LLC 2601 W Beltline Hwy Ste 302 Madison, WI (855) Wythe Wytheville SOUTHERN PHARMACY SERVICES 860 Stafford Umberger Dr Wytheville, VA (276) WISCONSIN Eau Claire Eau Claire PERSONIFILRX 800 Wisconsin Street Eau Claire, WI (715) Specialty Pharmacy ARIZONA Maricopa Phoenix LUMICERA HEALTH SERVICES, LLC 5350 E High St Ste 200 Phoenix, AZ (855) WISCONSIN Dane Madison Page 27

30 English: ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call TTY: 711 Multi-Language Interpreter Services Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al TTY: 711. Chinese: 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 TTY:711 Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số TTY: 711. Korean: 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수 있습니다 TTY: 711 번으로전화해주십시오. French: ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le ATS : 711. Arabic: برقم اتصل.بالمجان لك تتوافر اللغویة المساعدة خدمات فا ن اللغة اذكر تتحدث كنت إذا :ملحوظة (والبكم الصم ھاتف رقم: 711 ). Hmong: LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau TTY: 711. Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните телетайп: 711. Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa TTY: 711. Gujarati:!ચન : % ત' ગuજર ત બ લત હ, ત ન:શu3ક ભ ષ સહ ય 9વ ઓતમ ર મ = ઉપલ@ધ B. ફ ન કર (TTY: 711). Mon-Kmer, Cambodian: ប ស ន អ កន យ ខ រ, ស ជ ន យ ផ ក យម នគ តឈ ល គ ច នស ប ប រ អ ក ច រ ទ រស ព (TTY: 711) Hindi: य द आप ह द ब लत ह त आ प क लए म म भ ष सह यत स व ए उपल ह पर क ल कर Laotian: ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ TTY: 711. Japanese: 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます TTY:711 まで お電話にてご連絡ください German: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: H6351_2019MLINC_C

31 Discrimination is Against the Law Liberty Advantage complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Liberty Advantage does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Liberty Advantage: Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages If you need these services, contact our Compliance Officer If you believe that Liberty Advantage has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with our Compliance Officer, Liberty Advantage, P.O. Box 2190 Glen Allen, VA 23058, phone , TTY 711, fax , compliance@libertyadvantageplan.com. You can file a grievance in person or by mail, fax, or . If you need help filing a grievance our Compliance Officer is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C , (TDD) Complaint forms are available at