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RIDLEYS PHARMACY 8446
CH10165C FAMILY HEALTH SERVICES CORPORATION
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Covered Entity Details
Entity Name
FAMILY HEALTH SERVICES CORPORATION
Subdivision Name
FAMILY HEALTH SERVICES - BUHL MEDICAL AND DENTAL CLINIC
Type
HRSA-Funded Health Center
340B ID
CH10165C
Entity Address
725 FAIR ST
BUHL, ID 83316-6442
Grant Number
H80CS00425
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RIDLEYS PHARMACY 8446
Pharmacy Address
705 E US HWY 30
BUHL, ID 83316
Pharmacy Comments
Contract Details
Approval Date
4/2/2010
Contract Begin Date
4/2/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
1/5/2010
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