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ROAN MOUNTAIN PHARMACY
CHC24142-00 HIGH COUNTRY COMMUNITY HEALTH
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Covered Entity Details
Entity Name
HIGH COUNTRY COMMUNITY HEALTH
Subdivision Name
High Country Community Health: Watauga Center
Type
HRSA-Funded Health Center
340B ID
CHC24142-00
Entity Address
935 State Farm Road
Boone, NC 28607
Grant Number
H80CS24142
Participating Start Date
1/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ROAN MOUNTAIN PHARMACY
Pharmacy Address
8251 HWY 19E
ROAN MOUNTAIN, TN 37687-3343
Pharmacy Comments
Contract Details
Approval Date
7/6/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tiffany Melchers, CFO
(828) 262-3886 Ext: 120
Contract Pharmacy Representative
Roan Mountain Pharmacy
Jordon Baker, Pharmacist
(423) 772-3591
Signed By Date
7/6/2020
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