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AVITA PHARMACY 1058
CH042780 CAROLINA HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
CAROLINA HEALTH CENTERS, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH042780
Entity Address
313 MAIN STREET
SUITE B
GREENWOOD, SC 29646
Grant Number
H80CS00785
Participating Start Date
1/1/2004
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
AVITA PHARMACY 1058
Pharmacy Address
MEDEXPRESS PHARMACY, LTD. DBA AVITA PHAR
1431 W. INNES ST.
SALISBURY, NC 28144
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SUE VEER, CEO
(864) 388-0301 Ext: 68207
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
10/15/2024
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