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SOUTH GEORGIA DRUG COMPANY
CH043340 CareConnect Health, Inc.
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Covered Entity Details
Entity Name
CareConnect Health, Inc.
Subdivision Name
CareConnect Family Practice and Pediatrics
Type
HRSA-Funded Health Center
340B ID
CH043340
Entity Address
510 Alston Street
Suite A
Richland, GA 31825-1404
Grant Number
H80CS00393
Participating Start Date
4/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
SOUTH GEORGIA DRUG COMPANY
Pharmacy Address
DBA- FRIENDLY CITY PHARMACY
1202 US HIGHWAY 41 N
TIFTON, GA 31794-3202
Pharmacy Comments
Contract Details
Approval Date
4/12/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ajay Gehlot, CEO
(229) 273-8881
Contract Pharmacy Representative
Colony Discount Drugs, Inc
Lucas Brown, Manager/PIC
(229) 423-9801
Signed By Date
4/12/2021
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