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COROLLA PHARMACY
STD27929 CURRITUCK COUNTY HEALTH DEPARTMENT
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Covered Entity Details
Entity Name
CURRITUCK COUNTY HEALTH DEPARTMENT
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD27929
Entity Address
2795 CARATOKE HWY
CURRITUCK, NC 27929
Grant Number
5NH25PS005152-03-00
Participating Start Date
1/1/2009
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
COROLLA PHARMACY
Pharmacy Address
TODD'S PHARMACY OF CURRITUCK
532A CARATOKE HWY
PO BOX 520
MOYOCK, NC 27958-8740
Pharmacy Comments
Contract Details
Approval Date
4/8/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jerry Parks, Health Director
(252) 338-4405
Contract Pharmacy Representative
SUSAN TATUM, PHARMACIST
(252) 232-0278
Signed By Date
4/8/2014
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