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BI-LO PHARMACY #5707
CH041110 FETTER HEALTHCARE NETWORK INC.
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Covered Entity Details
Entity Name
FETTER HEALTHCARE NETWORK INC.
Subdivision Name
FRANKLIN C FETTER FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH041110
Entity Address
51 Nassau St
Charleston, SC 29403-5513
Grant Number
H80CS09088
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
BI-LO PHARMACY #5707
Pharmacy Address
550 ROBERTSON BLVD
WALTERBORO, SC 29488
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
6/3/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Aretha Jones, CEO
(843) 722-4112 Ext: 3004
Contract Pharmacy Representative
Southeastern Grociers
David Chism, Seinior Director
(904) 370-6455 Ext: 9043706455
Signed By Date
10/15/2018
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