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HOSPITAL DRIVE PHARMACY
CHC24141-01 MOUNTAIN COMMUNITY HEALTH PARTNERSHIP, INCORPORATED
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Covered Entity Details
Entity Name
MOUNTAIN COMMUNITY HEALTH PARTNERSHIP, INCORPORATED
Subdivision Name
Spruce Pine Health Center
Type
HRSA-Funded Health Center
340B ID
CHC24141-01
Entity Address
11728 South 226 Hwy
Spruce Pine, NC 28777-8943
Grant Number
H80CS24141
Participating Start Date
7/1/2013
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
HOSPITAL DRIVE PHARMACY
Pharmacy Address
409 ALTAPASS HWY
SPRUCE PINE, NC 28777
Pharmacy Comments
Contract Details
Approval Date
5/10/2023
Contract Begin Date
5/10/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chuck Shelton, CEO
(828) 688-2104
Contract Pharmacy Representative
Hospital Drive Pharmacy
Robert Gary Proffitt, Pharmacy Owner
(828) 765-2025
Signed By Date
5/10/2023
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