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GIANT PHARMACY 108
CH030150 Total Health Care, Inc.
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Covered Entity Details
Entity Name
Total Health Care, Inc.
Subdivision Name
Division Health Center
Type
HRSA-Funded Health Center
340B ID
CH030150
Entity Address
1501 DIVISION STREET
BALTIMORE, MD 21217
Grant Number
H80CS00068
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
GIANT PHARMACY 108
Pharmacy Address
6340 YORK RD
BALTIMORE, MD 21212
Pharmacy Comments
Contract Details
Approval Date
7/16/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/20/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Danny Bellamy, CEO
(410) 728-4090
Contract Pharmacy Representative
GIANT FOOD
KELLY SHANAHAN, DISTRICT PHARMACY MANAGER
(240) 461-2982
Signed By Date
7/16/2021
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