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KIM'S PHARMACY
FQHCLA434A MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
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Covered Entity Details
Entity Name
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
Subdivision Name
MAHEC Family Health Center at Enka/Candler
Type
Health Center Program Look-Alike
340B ID
FQHCLA434A
Entity Address
25 Westridge Market Pl
Candler, NC 28715-9174
Grant Number
LALCS45788
Participating Start Date
10/1/2022
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
KIM'S PHARMACY
Pharmacy Address
479 DELLWOOD RD
WAYNESVILLE, NC 28786
Pharmacy Comments
Contract Details
Approval Date
10/17/2022
Contract Begin Date
11/15/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William R Hathaway, CEO
(828) 257-4405
Contract Pharmacy Representative
Kim's Pharmacy
Kimberly Ferguson, Owner
(828) 452-2313
Signed By Date
10/17/2022
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