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PIEDMONT PHARMACY - NORTH
TB31811 HARRIS COUNTY BOARD OF HEALTH
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Covered Entity Details
Entity Name
HARRIS COUNTY BOARD OF HEALTH
Subdivision Name
GEORGIA WEST CENTRAL HEALTH DISTRICT 7 - TB CLINIC
Type
Tuberculosis
340B ID
TB31811
Entity Address
210 FOREST HILL DRIVE
HAMILTON, GA 31811
Grant Number
NU52PS910250
Participating Start Date
1/1/2001
Last Recertification Date
5/9/2025
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
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