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MOOSE COMPOUNDING PHARMACY
CH0445230 CABARRUS COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
CABARRUS COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
MCGILL FAMILY MEDICINE
Type
HRSA-Funded Health Center
340B ID
CH0445230
Entity Address
202D Mcgill Ave NW
Concord, NC 28025-4615
Grant Number
H80CS06652
Participating Start Date
7/1/2006
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MOOSE COMPOUNDING PHARMACY
Pharmacy Address
740 CHURCH ST N
CONCORD, NC 28025
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/11/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
Don Holloman, CEO
(704) 792-2203
Contract Pharmacy Representative
Moose Pharmacy
Joseph Moose, Owner
(704) 784-9613
Signed By Date
7/15/2022
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