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SUPER ONE PHARMACY #603
CH0627740 Morehouse Community Medical Centers, Inc.
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Covered Entity Details
Entity Name
Morehouse Community Medical Centers, Inc.
Subdivision Name
CommuniHealth Services - Bastrop Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH0627740
Entity Address
314 N Franklin Street
Bastrop, LA 71220
Grant Number
H80CS08764
Participating Start Date
7/1/2008
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SUPER ONE PHARMACY #603
Pharmacy Address
2211 E. MADISON AVE.
BASTROP, LA 71220
Pharmacy Comments
Contract Details
Approval Date
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/3/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Katie Parnell, CEO
(318) 239-8026
Contract Pharmacy Representative
Brookshire Grocery Company
Neil Ducote, Director of Pharmacy
(903) 600-1376
Signed By Date
7/14/2022
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