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HUB CITY DRUG
CH101650 FAMILY HEALTH SERVICES CORPORATION
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Covered Entity Details
Entity Name
FAMILY HEALTH SERVICES CORPORATION
Subdivision Name
FAMILY HEALTH SERVICES - ADMINISTRATION
Type
HRSA-Funded Health Center
340B ID
CH101650
Entity Address
794 Eastland Dr
Twin Falls, ID 83301-6856
Grant Number
H80CS00425
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HUB CITY DRUG
Pharmacy Address
447 N IDAHO ST
WENDELL, ID 83355
Pharmacy Comments
Contract Details
Approval Date
10/2/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aaron J Houston, CEO
(208) 734-3312 Ext: 6708
Contract Pharmacy Representative
K2RED LLC DBA HUB CITY DRUG
Dan Fuchs, Member
(208) 536-9968
Signed By Date
10/2/2019
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