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MANIFEST PHARMACY, LLC
CH032750 CHOPTANK COMMUNITY HEALTH SYSTEM, INC.
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Covered Entity Details
Entity Name
CHOPTANK COMMUNITY HEALTH SYSTEM, INC.
Subdivision Name
DENTON MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH032750
Entity Address
808 S 5th Ave
DENTON, MD 21629-1392
Grant Number
H80CS00176
Participating Start Date
4/1/1999
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
MANIFEST PHARMACY, LLC
Pharmacy Address
1018 S BATESVILLE RD
STE 4A
GREER, SC 29650-5203
Pharmacy Comments
Contract Details
Approval Date
4/10/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/21/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph M. Sheehan, President and CEO
(410) 479-4306
Contract Pharmacy Representative
Benjamin Walvoord, President
(864) 990-2880
Signed By Date
4/10/2013
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