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GLENNS APOTHECARY
STD420642 Family Practice Clinic
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Covered Entity Details
Entity Name
Family Practice Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD420642
Entity Address
518 West Gum St.
Marion, KY 42064
Grant Number
NH25PS005135
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
GLENNS APOTHECARY
Pharmacy Address
HILL PHARMACEUTICALS, LLC
520 WEST GUM STREET
PO BOX 366
MARION, KY 42064
Pharmacy Comments
Contract Details
Approval Date
5/18/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shawn Bright, CEO
(270) 965-1018
Contract Pharmacy Representative
Glenns Prescription Center
Tashena Hill, Owner
(270) 988-3226
Signed By Date
4/15/2025
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