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ANDERSON'S DRUG STORE, LLC
CAH341315-00 Bladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County Hospital
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Covered Entity Details
Entity Name
Bladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH341315-00
Entity Address
501 S. Poplar Street
Elizabethtown, NC 28337
Medicare Provider Number
341315
Participating Start Date
10/1/2011
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
ANDERSON'S DRUG STORE, LLC
Pharmacy Address
DBA ANDERSON'S DRUG STORE
206 S POPLAR ST
ELIZABETHTOWN, NC 28337
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen Fife, President & CFO
(910) 862-5149
Contract Pharmacy Representative
Anderson's Drug Store, LLC
Geena Anderson Peed, PIC/Owner
(910) 862-8411
Signed By Date
1/13/2020
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