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MED CENTER PHARMACY
CH0412790 RURAL HEALTH SERVICES CONSORTIUM
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Covered Entity Details
Entity Name
RURAL HEALTH SERVICES CONSORTIUM
Subdivision Name
HAWKINS MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH0412790
Entity Address
4966 HIGHWAY 11 WEST
ROGERSVILLE, TN 37857
Grant Number
H80CS00421
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MED CENTER PHARMACY
Pharmacy Address
900 WEST MAIN STREET
SUITE 2
ROGERSVILLE, TN 37857-3785
Pharmacy Comments
Contract Details
Approval Date
10/12/2012
Contract Begin Date
10/12/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/28/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
LINDA W. BUCK, CHIEF EXECUTIVE OFFICER
(423) 272-9163 Ext: 8901
Contract Pharmacy Representative
William Pack, Owner
(423) 272-8104
Signed By Date
9/20/2012
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