Contract Pharmacy Details

PRESCRIPTION CENTER INC
CH101188B Community Council of Idaho, Inc.

Covered Entity Details

Entity Name

Community Council of Idaho, Inc.

Subdivision Name

Community Family Clinic Idaho Falls

Type

HRSA-Funded Health Center

340B ID

CH101188B

Entity Address

2100 Alan STREET
IDAHO FALLS, ID 83404

Grant Number

H80CS04201

Participating Start Date

9/9/2005

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

PRESCRIPTION CENTER INC

Pharmacy Address

2252 CORONADO ST
IDAHO FALLS, ID 83404

Pharmacy Comments

Contract Details

Approval Date

4/28/2006

Contract Begin Date

4/28/2006

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

4/4/2006

340B Drug Pricing Program Database