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PILLPACK LLC
CHC17157-00 REGIONAL HEALTH CARE AFFILIATES, INC.
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Covered Entity Details
Entity Name
REGIONAL HEALTH CARE AFFILIATES, INC.
Subdivision Name
Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Providence
Type
HRSA-Funded Health Center
340B ID
CHC17157-00
Entity Address
215 East Main Street
Providence, KY 42450-1261
Grant Number
H80CS17157
Participating Start Date
7/1/2010
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
PILLPACK LLC
Pharmacy Address
DBA PILLPACK BY AMAZON PHARMACY
250 COMMERCIAL ST STE 2012
MANCHESTER, NH 03101
Pharmacy Comments
Contract Details
Approval Date
9/4/2020
Contract Begin Date
9/8/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/4/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Shelley Renea Gobin, CEO
(270) 667-2535 Ext: 2104
Contract Pharmacy Representative
PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725
Signed By Date
9/4/2020
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