Contract Pharmacy Details

GROVE PARK PHARMACY
CH041180 FAMILY HEALTH CENTERS, INC.

Covered Entity Details

Entity Name

FAMILY HEALTH CENTERS, INC.

Subdivision Name

Type

HRSA-Funded Health Center

340B ID

CH041180

Entity Address

3310 MAGNOLIA ST
ORANGEBURG, SC 29115

Grant Number

H80CS00090

Participating Start Date

12/1/1992

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

GROVE PARK PHARMACY

Pharmacy Address

1324 GROVE PARK DR
ORANGEBURG, SC 29115-2911

Pharmacy Comments

Contract Details

Approval Date

4/4/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/25/2017
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Leon A. Brunson Sr., CEO
(803) 531-6905

Contract Pharmacy Representative

Charles Thompson, Owner
(803) 536-0007

Signed By Date

4/4/2014