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TRENTON PHARMACY
CH044790 PRIMARY HEALTH CARE CENTER OF DADE, INC.
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Covered Entity Details
Entity Name
PRIMARY HEALTH CARE CENTER OF DADE, INC.
Subdivision Name
PRIMARY HEALTH CARE CENTER TRENTON
Type
HRSA-Funded Health Center
340B ID
CH044790
Entity Address
13570 N Main St
Trenton, GA 30752-2012
Grant Number
H80CS00649
Participating Start Date
1/1/1998
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
TRENTON PHARMACY
Pharmacy Address
NARAYAN 56 PHARMACY LLC
11969 S MAIN ST
TRENTON, GA 30752
Pharmacy Comments
Contract Details
Approval Date
4/3/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Christman, Chief Executive Officer
(706) 956-2665 Ext: 8549
Contract Pharmacy Representative
Trenton Pharmacy
Rita Shah, Owner
(706) 500-1301
Signed By Date
4/3/2025
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