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GUILFORD CTY HLTH DEPT PHARM
CHC26514-10 TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
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Covered Entity Details
Entity Name
TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
Subdivision Name
Family Medicine at Elm
Type
HRSA-Funded Health Center
340B ID
CHC26514-10
Entity Address
606 N Elm St
High Point, NC 27262-4332
Grant Number
H80CS26514
Participating Start Date
7/1/2022
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GUILFORD CTY HLTH DEPT PHARM
Pharmacy Address
501 E GREEN DR
HIGH POINT, NC 27260-6707
Pharmacy Comments
Contract Details
Approval Date
10/14/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle Lewis, CEO
(336) 355-9715
Contract Pharmacy Representative
Guilford County Health Department
Mary Elizabeth Batten, Director of Pharmacy
(336) 641-8037
Signed By Date
10/14/2022
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