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MIZELLES DISCOUNT DRUG CO INC
CHC08737-02 Roanoke Chowan Community Health Center, Inc.
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Covered Entity Details
Entity Name
Roanoke Chowan Community Health Center, Inc.
Subdivision Name
Murfreesboro Primay Care
Type
HRSA-Funded Health Center
340B ID
CHC08737-02
Entity Address
305 Beechwood Blvd
Murfreesboro, NC 27855-1134
Grant Number
H80CS08737
Participating Start Date
7/1/2005
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
MIZELLES DISCOUNT DRUG CO INC
Pharmacy Address
LOUIS E MIZELLE JR
925 E MEMORIAL DRIVE
AHOSKIE, NC 27910
Pharmacy Comments
Contract Details
Approval Date
10/15/2012
Contract Begin Date
10/15/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/22/2016
Ownership change
Contacts
Covered Entity Signing Official
KIM SCHWARTZ, CEO
(252) 209-0237 Ext: 7124
Contract Pharmacy Representative
Louis Mizelle, President
(252) 332-5034
Signed By Date
9/17/2012
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