Contract Pharmacy Details

MIZELLES DISCOUNT DRUG CO INC
CHC08737-03 Roanoke Chowan Community Health Center, Inc.

Covered Entity Details

Entity Name

Roanoke Chowan Community Health Center, Inc.

Subdivision Name

COLERAIN PRIMARY CARE

Type

HRSA-Funded Health Center

340B ID

CHC08737-03

Entity Address

109 W River St
Colerain, NC 27924-9006

Grant Number

H80CS08737

Participating Start Date

7/1/2007

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

7/10/2007

Contract Begin Date

7/10/2007

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/22/2016
Ownership change

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

6/25/2007

340B Drug Pricing Program Database