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GIANT PHARMACY #192
CHC10591-00 COMMUNITY CLINIC, INC.
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Covered Entity Details
Entity Name
COMMUNITY CLINIC, INC.
Subdivision Name
CCI-Takoma Park
Type
HRSA-Funded Health Center
340B ID
CHC10591-00
Entity Address
7676 NEW HAMPSHIRE AVENUE
Suite 200
TAKOMA PARK, MD 20912
Grant Number
H80CS10591
Participating Start Date
4/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
GIANT PHARMACY #192
Pharmacy Address
18250 FLOWER HILL WAY
GAITHERSBURG, MD 20879
Pharmacy Comments
Contract Details
Approval Date
7/27/2011
Contract Begin Date
7/27/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
7/6/2011
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