340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PIEDMONT PHARMACY - NORTH
TB31015 CRISP COUNTY BOARD OF HEALTH
Print
Covered Entity Details
Entity Name
CRISP COUNTY BOARD OF HEALTH
Subdivision Name
GEORGIA WEST CENTRAL HEALTH DISTRICT 7 - TB CLINIC
Type
Tuberculosis
340B ID
TB31015
Entity Address
111 East 24TH Avenue
CORDELE, GA 31015
Grant Number
NU52PS910250
Participating Start Date
1/1/2001
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
PIEDMONT PHARMACY - NORTH
Pharmacy Address
5601 VETERANS PKWY
STE 1800
COLUMBUS, GA 31904
Pharmacy Comments
Contract Details
Approval Date
10/9/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
MICHELLE L ALLEN, Infectious Diseases Section Director
(404) 463-2579
Contract Pharmacy Representative
Piedmont Pharmacy-North
Deborah Conkle, Pharmacy Director
(706) 321-3700
Signed By Date
10/9/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session