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KROGER FOOD AND DRUG #388
CH04244F 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.--BRANDON
Type
HRSA-Funded Health Center
340B ID
CH04244F
Entity Address
1551 W Government St
Brandon, MS 39042-2408
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
6/16/2010
Contract Begin Date
6/24/2010
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
6/10/2010
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