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FAMILY DRUG CENTER #3
CHC09959-01 GRACE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GRACE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Grace Health Manchester
Type
HRSA-Funded Health Center
340B ID
CHC09959-01
Entity Address
85 Highway 80
Manchester, KY 40962-1401
Grant Number
H80CS09959
Participating Start Date
10/1/2010
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
FAMILY DRUG CENTER #3
Pharmacy Address
214 BRIDGE STREET
MANCHESTER, KY 40962
Pharmacy Comments
Contract Details
Approval Date
11/15/2010
Contract Begin Date
11/15/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David Worthy, CEO
(606) 526-9005
Contract Pharmacy Representative
Daniel Gray, Owner/RPh
(606) 598-8831
Signed By Date
11/1/2010
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