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WELVISTA INC
CH04119J BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
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Covered Entity Details
Entity Name
BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
Subdivision Name
HAMPTON MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH04119J
Entity Address
200 Elm St E
Hampton, SC 29924-3430
Grant Number
H80CS00699
Participating Start Date
1/1/2004
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
WELVISTA INC
Pharmacy Address
WELVISTA
121 GREYSTONE BLVD
COLUMBIA, SC 29210
Pharmacy Comments
Contract Details
Approval Date
7/2/2010
Contract Begin Date
7/2/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/5/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/21/2010
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