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THE MEDICINE SHOPPE
CH04900B ROBESON HEALTH CARE CORP
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Covered Entity Details
Entity Name
ROBESON HEALTH CARE CORP
Subdivision Name
MAXTON MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH04900B
Entity Address
610 E. MARTIN LUTHER KING DR
MAXTON, NC 28364-1800
Grant Number
H80CS00107
Participating Start Date
1/1/1995
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
THE MEDICINE SHOPPE
Pharmacy Address
PHARMAX, INC.
102 N PATTERSON ST
MAXTON, NC 28364-1735
Pharmacy Comments
Contract Details
Approval Date
4/26/2004
Contract Begin Date
4/26/2004
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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