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MAIDEN DRUG COMPANY
CH04216A DAYSPRING HEALTH, INC.
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Covered Entity Details
Entity Name
DAYSPRING HEALTH, INC.
Subdivision Name
DAYSPRING JELLICO
Type
HRSA-Funded Health Center
340B ID
CH04216A
Entity Address
550 Sunset Trl
Jellico, TN 37762-2343
Grant Number
H80CS00716
Participating Start Date
10/1/1996
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MAIDEN DRUG COMPANY
Pharmacy Address
327 MAIN ST
WILLIAMSBURG, KY 40769-1123
Pharmacy Comments
Contract Details
Approval Date
7/9/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lawrence Michael Rector, CEO
(423) 784-8492 Ext: 221
Contract Pharmacy Representative
Riverbend Pharmacy
Ciera Swords, Pharmacist
(276) 639-2438
Signed By Date
7/9/2024
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