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THE MEDICINE MART
CH043270 EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Subdivision Name
EAU CLAIRE COOPERATIVE HEALTH CENTER ADMINISTRATIVE OFFICES
Type
HRSA-Funded Health Center
340B ID
CH043270
Entity Address
221 Dawson Road
COLUMBIA, SC 29223
Grant Number
H80CS00730
Participating Start Date
4/1/2002
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
THE MEDICINE MART
Pharmacy Address
1300 SUNSET BLVD
WEST COLUMBIA, SC 29169-5914
Pharmacy Comments
Contract Details
Approval Date
1/14/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
STUART A. HAMILTON, CEO
(803) 733-5969 Ext: 4125
Contract Pharmacy Representative
Lynn E. Connelly, Pharmacy Manager
(803) 791-7043
Signed By Date
1/3/2013
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