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FALLSTON PHARMACY INC
CH045630 GASTON FAMILY HEALTH SERVICES INC
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Covered Entity Details
Entity Name
GASTON FAMILY HEALTH SERVICES INC
Subdivision Name
Kintegra Family Medicine - Hudson
Type
HRSA-Funded Health Center
340B ID
CH045630
Entity Address
991 W Hudson Blvd
Gastonia, NC 28052-6430
Grant Number
H80CS00293
Participating Start Date
10/1/1997
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
FALLSTON PHARMACY INC
Pharmacy Address
5011 FALLSTON ROAD
P O BOX 418
FALLSTON, NC 28042
Pharmacy Comments
Contract Details
Approval Date
7/9/2022
Contract Begin Date
8/4/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Robert Spencer, CEO
(704) 616-2245
Contract Pharmacy Representative
Fallston Pharmacy, Inc.
William F Allen, Owner
(704) 538-3021
Signed By Date
7/9/2022
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