340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
IC PHARMACY LLC
CH047000 HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Print
Covered Entity Details
Entity Name
HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Subdivision Name
Health Care Partners of South Carolina, Inc. - Conway Administrative Office
Type
HRSA-Funded Health Center
340B ID
CH047000
Entity Address
1708 Oak Street
Conway, SC 29526-3086
Grant Number
H80CS00411
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
IC PHARMACY LLC
Pharmacy Address
AMAZON PHARMACY #004
34 35TH STREET
STE 4BSW, UNIT 28
BROOKLYN, NY 11232
Pharmacy Comments
Contract Details
Approval Date
7/16/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Santina Mayo, Chief Executive Officer
(843) 488-6034
Contract Pharmacy Representative
AMAZON PHARMACY
JOHN M LAVIN, MANAGING OFFICER
(602) 793-8552
Signed By Date
7/16/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session