Contract Pharmacy Details

FRED'S PHARMACY #2524
CH044150 ALBANY AREA PRIMARY HEALTH CARE, INC

Covered Entity Details

Entity Name

ALBANY AREA PRIMARY HEALTH CARE, INC

Subdivision Name

ALBANY AREA PRIMARY HEALTH CARE, INC.

Type

HRSA-Funded Health Center

340B ID

CH044150

Entity Address

204 N.WESTOVER BLVD.
ALBANY, GA 31707

Grant Number

H80CS00763

Participating Start Date

4/1/2003

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

FRED'S PHARMACY #2524

Pharmacy Address

2601 SOUTH MAIN STREET
MOULTRIE, GA 31768

Pharmacy Comments

Contract Details

Approval Date

1/7/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/26/2018
Pharmacy closed

Contacts

Covered Entity Signing Official

Shelley Spires, Chief Executive Officer
(229) 888-6559 Ext: 6209

Contract Pharmacy Representative

Fred's Pharmacy
Betty Ngo, Sr. Director 340B Program Operations
(901) 481-0346

Signed By Date

1/7/2017

340B Drug Pricing Program Database