Contract Pharmacy Details

QUINN PHARMACY
CH04057A FAMILY HEALTH CENTER INC

Covered Entity Details

Entity Name

FAMILY HEALTH CENTER INC

Subdivision Name

Family Health Center Taylorsville

Type

HRSA-Funded Health Center

340B ID

CH04057A

Entity Address

531 Hwy 28 E
Taylorsville, MS 39168

Grant Number

H80CS00538

Participating Start Date

4/1/2009

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

QUINN PHARMACY

Pharmacy Address

104 S 13TH AVE
LAUREL, MS 39440

Pharmacy Comments

3/1/10 ADDR CORR (WAS 3150 AUDABON DR.)

Contract Details

Approval Date

12/18/2009

Contract Begin Date

12/18/2009

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/2/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Rashad Ali, CEO
(601) 425-3033 Ext: 156

Contract Pharmacy Representative

LONNIE HICKS, PHARMACIST/MANAGER
(601) 428-0688

Signed By Date

12/8/2009