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LONGS CLOSED DOOR PHARMACY
HV00789 HOPEHEALTH, INC.
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Covered Entity Details
Entity Name
HOPEHEALTH, INC.
Subdivision Name
Type
Ryan White Part C
340B ID
HV00789
Entity Address
360 N. Irby Street
FLORENCE, SC 29501
Grant Number
H76HA00789
Participating Start Date
7/1/2003
Last Recertification Date
2/20/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
LONGS CLOSED DOOR PHARMACY
Pharmacy Address
111 EXECUTIVE CENTER DR
STE 222
COLUMBIA, SC 29210-8425
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Carl Humphries, CEO
(843) 667-9414 Ext: 1500
Contract Pharmacy Representative
Long's Drugs
Christi Epps, PharmD
(404) 270-9242
Signed By Date
10/15/2018
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