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OSMAN PHARMACY
STD41179 Fresh Start Health PSC
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Covered Entity Details
Entity Name
Fresh Start Health PSC
Subdivision Name
Vanceburg Site
Type
Sexually Transmitted Diseases
340B ID
STD41179
Entity Address
207 Plummers Lane
Vanceburg, KY 41179
Grant Number
6NH25PS005135-01-01
Participating Start Date
1/1/2024
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
OSMAN PHARMACY
Pharmacy Address
MEGAL INVESTMENTS LLC
89 SECOND ST
VANCEBURG, KY 41179-5439
Pharmacy Comments
Contract Details
Approval Date
1/9/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jerrel Boyer, Medical Director
(606) 923-1124 Ext: 6062258298
Contract Pharmacy Representative
Osman Pharmacy
Chris McGlone, Owner
(606) 796-2451
Signed By Date
1/9/2024
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