Contract Pharmacy Details

REALO DISCOUNT DRUGS
CH045800 GOSHEN MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

GOSHEN MEDICAL CENTER, INC.

Subdivision Name

GOSHEN MEDICAL CENTER, INC.

Type

HRSA-Funded Health Center

340B ID

CH045800

Entity Address

444 SW Center St
Faison, NC 28341

Grant Number

H80CS00181

Participating Start Date

7/1/2003

Last Recertification Date

3/10/2025

Pharmacy Details

Pharmacy Name

REALO DISCOUNT DRUGS

Pharmacy Address

515 E NEW HOPE RD
GOLDSBORO, NC 27534-7004

Pharmacy Comments

Contract Details

Approval Date

4/15/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/22/2020
Pharmacy closed

Contacts

Covered Entity Signing Official

GREG BOUNDS, CEO
(910) 267-1942 Ext: 1117

Contract Pharmacy Representative

Realo Discount Drug
Hardy W. Creech II, Vice President
(252) 527-6929

Signed By Date

4/15/2020

340B Drug Pricing Program Database