Contract Pharmacy Details

FRED'S PHARMACY #1561
CH044710 FRANKLIN PRIMARY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

FRANKLIN PRIMARY HEALTH CENTER, INC.

Subdivision Name

FRANKLIN MEDICAL MALL

Type

HRSA-Funded Health Center

340B ID

CH044710

Entity Address

1303 DR. MARTIN LUTHER KING
MOBILE, AL 36603-5398

Grant Number

H80CS00099

Participating Start Date

1/1/1994

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

FRED'S PHARMACY #1561

Pharmacy Address

450 W FRONT ST
EVERGREEN, AL 36401-3279

Pharmacy Comments

Contract Details

Approval Date

4/25/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/19/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Charles White, Chief Executive Officer
(251) 434-8188

Contract Pharmacy Representative

Fred's Pharmacy
Nicole Pearson, 340B Program Manager
(901) 500-6153

Signed By Date

4/25/2017

340B Drug Pricing Program Database