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CENTERWELL PHARMACY, INC.
CHC12890-00 FAIRFIELD COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
FAIRFIELD COMMUNITY HEALTH CENTER
Subdivision Name
FCHC South
Type
HRSA-Funded Health Center
340B ID
CHC12890-00
Entity Address
220 E Walnut St
Lancaster, OH 43130-4464
Grant Number
H80CS19595
Participating Start Date
7/1/2010
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CENTERWELL PHARMACY, INC.
Pharmacy Address
10737 MARKS WAY
MIRAMAR, FL 33025
Pharmacy Comments
Contract Details
Approval Date
4/1/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/4/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Kim Rase-Shuttleworth, Revenue Specialist
(740) 277-6043 Ext: 1011
Contract Pharmacy Representative
Centerwell
Shelley Duke, Director, Specialty Pharmacy Contracting and Infusion
(502) 994-8732
Signed By Date
4/1/2021
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