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CARTER'S PHARMACY
CAH111306-00 EFFINGHAM HEALTH SYSTEM
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Covered Entity Details
Entity Name
EFFINGHAM HEALTH SYSTEM
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH111306-00
Entity Address
459 HIGHWAY 119 SOUTH
SPRINGFIELD, GA 31329-3021
Medicare Provider Number
111306
Participating Start Date
1/1/2011
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
CARTER'S PHARMACY
Pharmacy Address
CARTER'S PHAMACY,INC
STE.#10
1017 E. HIGHWAY 80
POOLER, GA 31322
Pharmacy Comments
Contract Details
Approval Date
1/23/2012
Contract Begin Date
1/25/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Norma Morgan, CEO
(912) 754-0480
Contract Pharmacy Representative
Carter's Phamacy,Inc
Amy C Carter, Owner
(912) 748-1414
Signed By Date
1/18/2012
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