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NORTHSIDE FAMILY PHARMACY
CH04668B1 RURAL HEALTH GROUP, INC.
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Covered Entity Details
Entity Name
RURAL HEALTH GROUP, INC.
Subdivision Name
Rural Health Group Pediatrics and Dental
Type
HRSA-Funded Health Center
340B ID
CH04668B1
Entity Address
2064 NC HIGHWAY 125
ROANOKE RAPIDS, NC 27870-9436
Grant Number
H80CS00866
Participating Start Date
1/1/2008
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
NORTHSIDE FAMILY PHARMACY
Pharmacy Address
3920 BISHOP ROAD
BATTLEBORO, NC 27809
Pharmacy Comments
Contract Details
Approval Date
3/24/2011
Contract Begin Date
3/24/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
3/23/2011
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