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PITTMAN'S PHARMACY
CH04919A BERTIE COUNTY RURAL HEALTH ASSOCIATION
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Covered Entity Details
Entity Name
BERTIE COUNTY RURAL HEALTH ASSOCIATION
Subdivision Name
LEWISTON-WOODVILLE FAMILY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH04919A
Entity Address
307 SOUTH MAIN STREET
LEWISTON, NC 27849
Grant Number
H80CS00355
Participating Start Date
10/1/2004
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
PITTMAN'S PHARMACY
Pharmacy Address
305 WEST GRANVILLE STREET
WINDSOR, NC 27983
Pharmacy Comments
Contract Details
Approval Date
10/1/2004
Contract Begin Date
10/1/2004
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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