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WALLACE DRUG COMPANY INC
CH040570 FAMILY HEALTH CENTER INC
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTER INC
Subdivision Name
FAMILY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH040570
Entity Address
117 S 11th Ave
Laurel, MS 39440-4312
Grant Number
H80CS00538
Participating Start Date
10/1/1995
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALLACE DRUG COMPANY INC
Pharmacy Address
520 N MAGNOLIA ST
LAUREL, MS 39440-3559
Pharmacy Comments
Contract Details
Approval Date
1/18/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rashad Ali, CEO
(601) 425-3033 Ext: 156
Contract Pharmacy Representative
Joe Robertson, owner
(601) 428-4334
Signed By Date
1/18/2017
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