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AHSSHC
CH03377A GREATER BADEN MEDICAL SERVICE INC
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Covered Entity Details
Entity Name
GREATER BADEN MEDICAL SERVICE INC
Subdivision Name
Greater Baden Medical Services at La Plata
Type
HRSA-Funded Health Center
340B ID
CH03377A
Entity Address
6 Garrett Avenue
La Plata, MD 20643
Grant Number
H80CS00549
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AHSSHC
Pharmacy Address
EXPEDIEN RX PHARMACY
5050 WESLEY RD STE 120
APOPKA, FL 32712
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher A DeMarco, Chief Executive Officer
(301) 888-2233 Ext: 3306
Contract Pharmacy Representative
Agape
Trenia Yielding, Executive Director
(407) 357-2601
Signed By Date
7/15/2019
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