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STROM'S DRUG STORE #2
CAH421301-00 ABBEVILLE COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
ABBEVILLE COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH421301-00
Entity Address
420 THOMSON CIRCLE
ABBEVILLE, SC 29620
Medicare Provider Number
421301
Participating Start Date
8/19/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
STROM'S DRUG STORE #2
Pharmacy Address
124 S MAIN ST
MC CORMICK, SC 29835-8345
Pharmacy Comments
Contract Details
Approval Date
4/1/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TIMOTHY WREN, CFO
(864) 366-3310
Contract Pharmacy Representative
Strom's Drug Store
William Matheny, Pharmacist
(864) 465-2011
Signed By Date
4/1/2016
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