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PUBLIX NORTH CAROLINA, LP
FQHCLA434D MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
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Covered Entity Details
Entity Name
MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
Subdivision Name
MAHEC Cane Creek Primary Care Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA434D
Entity Address
1542 Cane Creek Rd
Fletcher, NC 28732-7423
Grant Number
LALCS45788
Participating Start Date
10/1/2022
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PUBLIX NORTH CAROLINA, LP
Pharmacy Address
PUBLIX PHARMACY #1640
124 FRAZIER ST
WAYNESVILLE, NC 28786
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William R Hathaway, CEO
(828) 257-4405
Contract Pharmacy Representative
Publix
Amin Mrugesh, 340B Program Manager
(863) 688-1188 Ext: 52388
Signed By Date
4/15/2024
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