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DIXIE CITY PHARMACY
CH040390 MEDLINK GEORGIA, INC.
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Covered Entity Details
Entity Name
MEDLINK GEORGIA, INC.
Subdivision Name
Medlink Colbert
Type
HRSA-Funded Health Center
340B ID
CH040390
Entity Address
11 CHARLIE MORRIS RD
COLBERT, GA 30628
Grant Number
H80CS00427
Participating Start Date
7/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
DIXIE CITY PHARMACY
Pharmacy Address
DIXIE CITY PHARMACY
1079 JESSE JEWELL PKWY SW
GAINESVILLE, GA 30501-3050
Pharmacy Comments
Contract Details
Approval Date
7/2/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/5/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
Dave Ward, CEO
(706) 788-3234
Contract Pharmacy Representative
Eddie Mimbs, Pharmacist
(770) 536-3108
Signed By Date
7/2/2013
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