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HARTWELL RX INC
CH04039D MEDLINK GEORGIA, INC
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Covered Entity Details
Entity Name
MEDLINK GEORGIA, INC
Subdivision Name
MEDLINK HARTWELL
Type
HRSA-Funded Health Center
340B ID
CH04039D
Entity Address
63 W. GIBSON ST
HARTWELL, GA 30643
Grant Number
H80CS00427
Participating Start Date
7/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HARTWELL RX INC
Pharmacy Address
DBA HARTWELL DRUGS
118 ATHENS STREET
HARTWELL, GA 30643
Pharmacy Comments
Contract Details
Approval Date
1/15/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2016
Agreement registered in error
Contacts
Covered Entity Signing Official
Dave Ward, CEO
(706) 788-3234
Contract Pharmacy Representative
CORPORATION
Lance Boles, Owner/Pharmacist
(706) 376-5801
Signed By Date
1/15/2016
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