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MAIN STREET PHARMACY
CH04656D HARDIN COUNTY REGIONAL HEALTH CENTER
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Covered Entity Details
Entity Name
HARDIN COUNTY REGIONAL HEALTH CENTER
Subdivision Name
Lifespan Clifton
Type
HRSA-Funded Health Center
340B ID
CH04656D
Entity Address
207 MAIN STREET
CLIFTON, TN 38425
Grant Number
H80CS00180
Participating Start Date
10/1/2006
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
MAIN STREET PHARMACY
Pharmacy Address
APOTHECARY CONSULTANTS, LLC
110 MAIN ST
SAVANNAH, TN 38372-2412
Pharmacy Comments
Contract Details
Approval Date
7/16/2010
Contract Begin Date
7/16/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
7/6/2010
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