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SERVICE REXALL DRUGS
CH04244E 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.--MENDENHALL
Type
HRSA-Funded Health Center
340B ID
CH04244E
Entity Address
401 Main St N
Mendenhall, MS 39114-3303
Grant Number
H80CS00487
Participating Start Date
7/1/2007
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
SERVICE REXALL DRUGS
Pharmacy Address
3069 SIMPSON HIGHWAY 13
MENDENHALL, MS 39114-3077
Pharmacy Comments
10/31/2013 Admin note - Pharmacy moved from 167 MAIN STREET N MENDENHALL, MS 39114 in April 2012
Contract Details
Approval Date
3/9/2011
Contract Begin Date
3/16/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
3/3/2011
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