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OVERLAKE PHARMACY, LLC
CH04102J GREENE COUNTY HEALTH CARE, INCORPORATED
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Covered Entity Details
Entity Name
GREENE COUNTY HEALTH CARE, INCORPORATED
Subdivision Name
Pamlico Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH04102J
Entity Address
313 MAIN ST
BAYBORO, NC 28515-9529
Grant Number
H80CS00088
Participating Start Date
4/1/2012
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
OVERLAKE PHARMACY, LLC
Pharmacy Address
4124 148TH AVE NE STE JA
REDMOND, WA 98052
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vito Veneruso, Chief Operating Officer
(252) 253-0962
Contract Pharmacy Representative
Truepill
Umar Afridi, Representative
(650) 353-5495
Signed By Date
10/11/2023
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