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NANTASKET PHARMACY INC
CH01164A MANET COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
MANET COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
MANET CHC AT HULL
Type
HRSA-Funded Health Center
340B ID
CH01164A
Entity Address
180 George Washington Blvd
Hull, MA 02045-3069
Grant Number
H80CS00453
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
NANTASKET PHARMACY INC
Pharmacy Address
480 NANTASKET AVE
HULL, MA 02045
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
4/1/2004
Carve-In Effective Date
Contract Comments
12/14/2005 - CORRECTION IN CONTRACT BEGIN DATE, INCORRECTLY GIVEN CONTRACT BEGIN DATE OF 3/18/2004 ORIGINALLY
Contract Termination Date
Termination Reason
8/29/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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