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BI-LO PHARMACY #5525
CH041190 BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
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Covered Entity Details
Entity Name
BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
Subdivision Name
RUTH P. FIELD MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH041190
Entity Address
719 N Okatie Hwy
Ridgeland, SC 29936-8276
Grant Number
H80CS00699
Participating Start Date
12/1/1992
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
BI-LO PHARMACY #5525
Pharmacy Address
860 PARIS ISLAND GATEWAY
SUITE N
BEAUFORT, SC 29906
Pharmacy Comments
05/07/2012 state correction (submitted as NC); 04/30/2012 added store #, suite
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/2/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Roland J Gardner, CEO
(843) 987-7448 Ext: 7448
Contract Pharmacy Representative
Vanessa Rhoden, 340B Program Manager
(904) 485-8108
Signed By Date
7/17/2017
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