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COUNTY SQUARE PHARMACY INC
CH011640 MANET COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
MANET COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
MANET COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH011640
Entity Address
Manet Pharmacy
110 W Squantum St
Quincy, MA 02171-2122
Grant Number
H80CS00453
Participating Start Date
4/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
COUNTY SQUARE PHARMACY INC
Pharmacy Address
289 COUNTY ST
ATTLEBORO, MA 02703
Pharmacy Comments
Contract Details
Approval Date
7/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CYNTHIA SIERRA, Chief Executive Officer
(617) 404-4101
Contract Pharmacy Representative
County Square Pharmacy, Inc.
Abram Agayby, President
(508) 742-8773
Signed By Date
7/12/2024
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