Contract Pharmacy Details

PUBLIX NORTH CAROLINA, LP
CH044523G Cabarrus Community Health Centers, Inc.

Covered Entity Details

Entity Name

Cabarrus Community Health Centers, Inc.

Subdivision Name

Temporary Site - Mobile Van (RV Testing Unit)

Type

HRSA-Funded Health Center

340B ID

CH044523G

Entity Address

202D Mcgill Ave NW
Concord, NC 28025-4615

Grant Number

H80CS06652

Participating Start Date

10/1/2020

Last Recertification Date

1/30/2024

Entity Termination Date

1/1/2025

Pharmacy Details

Pharmacy Name

PUBLIX NORTH CAROLINA, LP

Pharmacy Address

PUBLIX PHARMACY #1490
5015 WEDDINGTON RD.
CONCORD, NC 28027

Pharmacy Comments

Contract Details

Approval Date

7/31/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Don Holloman, CEO
(704) 792-2203

Contract Pharmacy Representative

Publix Super Markets
Dain Rusk, Vice President Pharmacy
(863) 616-5846

Signed By Date

7/30/2020

340B Drug Pricing Program Database