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POLARIS PHARMACY SERVICES OF MARYLAND, L
CHC24175-02 Family and Medical Counseling Service Inc
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Covered Entity Details
Entity Name
Family and Medical Counseling Service Inc
Subdivision Name
FMCS Mobile
Type
HRSA-Funded Health Center
340B ID
CHC24175-02
Entity Address
2041 Martin Luther King Jr Ave SE
Washington, DC 20020-7024
Grant Number
H80CS24175
Participating Start Date
1/1/2023
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
POLARIS PHARMACY SERVICES OF MARYLAND, L
Pharmacy Address
7200 RUTHERFORD RD STE 170
WINDSOR MILL, MD 21244
Pharmacy Comments
Contract Details
Approval Date
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Flora Terrell Hamilton, CEO
(202) 889-7900 Ext: 217
Contract Pharmacy Representative
Poaris Specialty Pharmacy
David Rombro, CEO
(954) 919-1818
Signed By Date
4/12/2024
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