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RIVER MEDICAL PHARMACY LLC
CH019980 GOODWIN COMMUNITY HEALTH
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Covered Entity Details
Entity Name
GOODWIN COMMUNITY HEALTH
Subdivision Name
Somersworth Facility
Type
HRSA-Funded Health Center
340B ID
CH019980
Entity Address
311 Route 108
Somersworth, NH 03878-1522
Grant Number
H80CS04210
Participating Start Date
4/1/2001
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
Pharmacy Comments
Contract Details
Approval Date
1/10/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANET LAATSCH, EXECUTIVE DIRECTOR
(603) 516-2550
Contract Pharmacy Representative
CarepathRx Health System Solution
Ryan Rushing, Vice President, 340B Solutions
(512) 541-0665
Signed By Date
1/10/2019
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