Contract Pharmacy Details

RITE AID OF GEORGIA, INC.
CH040390 MEDLINK GEORGIA, INC.

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

RITE AID OF GEORGIA, INC.

Pharmacy Address

RITE AID #1753
859 FRANKLIN SPRINGS STREET
ROYSTON, GA 30662

Pharmacy Comments

Contract Details

Approval Date

7/9/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/1/2018
Ownership change

Contacts

Covered Entity Signing Official

Dave Ward, CEO
(706) 788-3234

Contract Pharmacy Representative

PDS I Michigan, Inc
Allison Farrell, Senior Vice President
(717) 214-8834

Signed By Date

7/9/2013

340B Drug Pricing Program Database