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RIVER MEDICAL PHARMACY LLC
CH047430 GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
Subdivision Name
GHMS Cumming Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH047430
Entity Address
260 Elm St
Cumming, GA 30040-2467
Grant Number
H80CS00470
Participating Start Date
1/1/2005
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
Pharmacy Comments
Contract Details
Approval Date
4/12/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/4/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Todd Shifflet, CEO
(770) 887-1668 Ext: 1102
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
4/12/2019
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