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NICKMAN'S DRUG, #139
CH033090 CORNERSTONE CARE, INC.
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Covered Entity Details
Entity Name
CORNERSTONE CARE, INC.
Subdivision Name
Cornerstone Care Community Health Center of Greensboro
Type
HRSA-Funded Health Center
340B ID
CH033090
Entity Address
7 Glassworks Rd
GREENSBORO, PA 15338
Grant Number
H80CS00401
Participating Start Date
12/1/1992
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
NICKMAN'S DRUG, #139
Pharmacy Address
1878 MCCLELLANDTOWN RD
MASONTOWN, PA 15461-2508
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nicole M. Coneybeer, Pharmacy Program Administrator
(724) 324-9001 Ext: 1783
Contract Pharmacy Representative
NICKMAN'S DRUG
JAMES NICKMAN Jr., PRESIDENT
(724) 437-2144
Signed By Date
4/15/2022
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