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MEDITHRIFT PHARMACY INC
CH04479F PRIMARY HEALTH CARE CENTER OF DADE, INC.
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Covered Entity Details
Entity Name
PRIMARY HEALTH CARE CENTER OF DADE, INC.
Subdivision Name
Primary Health Care Center Summerville
Type
HRSA-Funded Health Center
340B ID
CH04479F
Entity Address
11638 HIGHWAY 27
SUMMERVILLE, GA 30747-8514
Grant Number
H80CS00649
Participating Start Date
4/1/2016
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
MEDITHRIFT PHARMACY INC
Pharmacy Address
324 WEST PATTON STREET
P.O. BOX 791
LAFAYETTE, GA 30728
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DIANA U. ALLEN, CEO
(706) 620-4494 Ext: 8549
Contract Pharmacy Representative
Medithrift Pharmacy Inc.
Heather Staton, Owner
(706) 638-3114
Signed By Date
1/16/2024
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