340B Drug Pricing Program Database
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MEDICINE SHOPPE
FQHCLA422D FAITH HEALTHCARE INC
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Covered Entity Details
Entity Name
FAITH HEALTHCARE INC
Subdivision Name
Paintsville Community Care
Type
Health Center Program Look-Alike
340B ID
FQHCLA422D
Entity Address
236 College St
Paintsville, KY 41240-1098
Grant Number
LALCS40209
Participating Start Date
10/1/2023
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MEDICINE SHOPPE
Pharmacy Address
900 E MOUNT VERNON ST
SOMERSET, KY 42501
Pharmacy Comments
Contract Details
Approval Date
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Morgan Dishman, Chief Pharmacy Officer/340B Program Director
(270) 585-9726
Contract Pharmacy Representative
Medicine Shoppe
Sai Appalaneni, Owner
(606) 679-7695
Signed By Date
10/1/2024
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