Contract Pharmacy Details

MADDEN'S PHARMACY 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

MADDEN'S PHARMACY INC.

Pharmacy Address

101 COLLEGE AVE.
ELBERTON, GA 30635

Pharmacy Comments

Contract Details

Approval Date

7/11/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/13/2017
Agreement registered in error

Contacts

Covered Entity Signing Official

Dave Ward, CEO
(706) 788-3234

Contract Pharmacy Representative

Donald Piela Jr., Pharm D
(706) 283-1701

Signed By Date

7/11/2016