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KROGER FOOD AND DRUG #388
CH042440 FAMILY HEALTH CARE CLINIC, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CARE CLINIC, INC.
Subdivision Name
FAMILY HEALTH CARE CLINIC, INC.--PEARL
Type
HRSA-Funded Health Center
340B ID
CH042440
Entity Address
4635 Highway 80 E
Pearl, MS 39208-4226
Grant Number
H80CS00487
Participating Start Date
7/1/2007
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
KROGER FOOD AND DRUG #388
Pharmacy Address
1811 WEST GOVERNMENT STREET
BRANDON, MS 39042
Pharmacy Comments
Contract Details
Approval Date
1/15/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARGARET A. GRAY, PRESIDENT & CEO
(601) 825-7280 Ext: 5005
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
1/15/2016
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