Contract Pharmacy Details

MANIFEST PHARMACY, LLC
CH0423590 Tandem Health SC

Covered Entity Details

Entity Name

Tandem Health SC

Subdivision Name

Tandem Health

Type

HRSA-Funded Health Center

340B ID

CH0423590

Entity Address

1278 North Lafayette Drive
Sumter, SC 29150-2964

Grant Number

H80CS00868

Participating Start Date

1/1/2004

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

MANIFEST PHARMACY, LLC

Pharmacy Address

1018 S BATESVILLE RD
STE 4A
GREER, SC 29650-5203

Pharmacy Comments

Contract Details

Approval Date

7/1/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2016
Pharmacy closed

Contacts

Covered Entity Signing Official

Annie Brown, CEO/Executive Director
(803) 774-4545

Contract Pharmacy Representative

Benjamin Walvoord, President
(864) 990-2880

Signed By Date

7/1/2013