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THE PRESCRIPTION SHOP
CH04656F HARDIN COUNTY REGIONAL HEALTH CENTER
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Covered Entity Details
Entity Name
HARDIN COUNTY REGIONAL HEALTH CENTER
Subdivision Name
LIFESPAN HEALTH
Type
HRSA-Funded Health Center
340B ID
CH04656F
Entity Address
105 DAVIS STREET
SAVANNAH, TN 38372
Grant Number
H80CS00180
Participating Start Date
4/1/2010
Last Recertification Date
2/3/2021
Entity Termination Date
1/1/2022
Pharmacy Details
Pharmacy Name
THE PRESCRIPTION SHOP
Pharmacy Address
765 FLORENCE RD
STE B
SAVANNAH, TN 38372-5219
Pharmacy Comments
Contract Details
Approval Date
7/16/2010
Contract Begin Date
7/16/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
7/6/2010
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