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COLONY DISCOUNT DRUGS INC
CHC00836-11 South Central Primary Care Center, Inc.
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Covered Entity Details
Entity Name
South Central Primary Care Center, Inc.
Subdivision Name
South Central Primary Care Center - Administrative Building
Type
HRSA-Funded Health Center
340B ID
CHC00836-11
Entity Address
204 E. 4th St.
Ocilla, GA 31774-1539
Grant Number
H80CS00836
Participating Start Date
10/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
COLONY DISCOUNT DRUGS INC
Pharmacy Address
502 S GRANT ST
FITZGERALD, GA 31750
Pharmacy Comments
Contract Details
Approval Date
4/9/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert B. Tucker, CEO
(229) 468-9166 Ext: 1
Contract Pharmacy Representative
Colony Discount Drugs, Inc
Lucas Brown, Manager/PIC
(229) 423-9801
Signed By Date
4/9/2021
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