340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PHARMBLUE NORTH CAROLINA LLC
CH04392C MANTACHIE RURAL HEALTH CARE INC
Print
Covered Entity Details
Entity Name
MANTACHIE RURAL HEALTH CARE INC
Subdivision Name
Mantachie Rural Health Care Behavioral Health Clinic
Type
HRSA-Funded Health Center
340B ID
CH04392C
Entity Address
5510 Highway 363
Mantachie, MS 38855
Grant Number
H80CS00096
Participating Start Date
4/1/2018
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE NORTH CAROLINA LLC
Pharmacy Address
300 N GRACE ST.
SUITE 150
ROCKY MOUNT, NC 27804
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
MARJORIE MCKINNEY, CEO
(662) 282-4226 Ext: 114
Contract Pharmacy Representative
PharmBlue, LLC
Joseph P. Pohl III, CEO
(724) 779-4720 Ext: 033
Signed By Date
10/15/2020
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