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FAMILY PHARMACY OF LOUISBURG
FP275490 FRANKLIN COUNTY HEALTH DEPARTMENT
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Covered Entity Details
Entity Name
FRANKLIN COUNTY HEALTH DEPARTMENT
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP275490
Entity Address
107 INDUSTRIAL DRIVE
SUITE C
LOUISBURG, NC 27549
Grant Number
5 FPHPA006555-04-00
Participating Start Date
1/1/1998
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
FAMILY PHARMACY OF LOUISBURG
Pharmacy Address
SOUTHALL
339 S BICKETT BLVD
LOUISBURG, NC 27549-2754
Pharmacy Comments
Contract Details
Approval Date
4/2/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott LaVigne, Health Director
(919) 496-8111
Contract Pharmacy Representative
Family Pharmacy of Louisburg, L.L.C.
Jarrett Southall, Owner
(919) 340-1100
Signed By Date
4/2/2019
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