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BOONE DRUG AT KINGSTREET
CHC24142-05 HIGH COUNTRY COMMUNITY HEALTH
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Covered Entity Details
Entity Name
HIGH COUNTRY COMMUNITY HEALTH
Subdivision Name
High Country Community Health: Watauga Dental
Type
HRSA-Funded Health Center
340B ID
CHC24142-05
Entity Address
108 Doctors Drive
Boone, NC 28607
Grant Number
H80CS24142
Participating Start Date
1/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
BOONE DRUG AT KINGSTREET
Pharmacy Address
202 W KING ST
BOONE, NC 28607-3516
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tiffany Melchers, CFO
(828) 262-3886 Ext: 120
Contract Pharmacy Representative
Mountain City Pharmacy
Corey Furman, President
(423) 727-0038
Signed By Date
4/14/2020
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