Contract Pharmacy Details

PRESCRIPTION CENTER INC
CH101188C Community Council of Idaho, Inc.

Covered Entity Details

Entity Name

Community Council of Idaho, Inc.

Subdivision Name

Community Family Clinic Rigby

Type

HRSA-Funded Health Center

340B ID

CH101188C

Entity Address

4002 E. 397 N. STE 3
Rigby, ID 83442

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