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BRUNSON'S PHARMACY, LLC
HV00789 HOPEHEALTH, INC.
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Covered Entity Details
Entity Name
HOPEHEALTH, INC.
Subdivision Name
Type
Ryan White Part C
340B ID
HV00789
Entity Address
360 N. Irby Street
FLORENCE, SC 29501
Grant Number
H76HA00789
Participating Start Date
7/1/2003
Last Recertification Date
2/20/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
BRUNSON'S PHARMACY, LLC
Pharmacy Address
12 N BROOKS ST
PO BOX 1250
MANNING, SC 29102-3206
Pharmacy Comments
Contract Details
Approval Date
1/15/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/27/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Carl Humphries, CEO
(843) 667-9414 Ext: 1500
Contract Pharmacy Representative
Jamie Mathis, PIC
(803) 435-2511
Signed By Date
1/15/2014
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