Contract Pharmacy Details

MOSELEY DRUG CO
CH04415G ALBANY AREA PRIMARY HEALTH CARE, INC

Covered Entity Details

Entity Name

ALBANY AREA PRIMARY HEALTH CARE, INC

Subdivision Name

DAWSON MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH04415G

Entity Address

420 Johnson St SE
Dawson, GA 39842-1523

Grant Number

H80CS00763

Participating Start Date

4/1/2003

Last Recertification Date

2/17/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

MOSELEY DRUG CO

Pharmacy Address

412 JOHNSON ST SE
PO BOX 5
DAWSON, GA 39842

Pharmacy Comments

Contract Details

Approval Date

8/27/2010

Contract Begin Date

8/27/2010

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/11/2017
Covered Entity Terminated

Contacts

Covered Entity Signing Official

TARY BROWN, CEO
(228) 888-6559 Ext: 204

Contract Pharmacy Representative

TARA JACKSON, OWNER
(229) 995-2126

Signed By Date

8/16/2010