Contract Pharmacy Details

SCIENCE HILL DRUG
FQHCLA422 Faith Healthcare, Inc

Covered Entity Details

Entity Name

Faith Healthcare, Inc

Subdivision Name

Community Care Clinic, Inc.

Type

Health Center Program Look-Alike

340B ID

FQHCLA422

Entity Address

126 Franklin Rd
Monticello, KY 42633-2245

Grant Number

LALCS40209

Participating Start Date

3/12/2021

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

SCIENCE HILL DRUG

Pharmacy Address

5775 N HIGHWAY 27 STE 10
SCIENCE HILL, KY 42553-9150

Pharmacy Comments

Contract Details

Approval Date

3/11/2021

Contract Begin Date

3/12/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Timothy Carnes, 340B Program Co-Director/Chief Pharmacy Officer
(270) 566-1074

Contract Pharmacy Representative

Science Hill Drug
Jessica Tanner, Pharmacist
(606) 423-9959

Signed By Date

3/11/2021

340B Drug Pricing Program Database