Contract Pharmacy Details

HPB INC.
RWIID303031 GEORGIA DEPT OF PUBLIC HEALTH

Covered Entity Details

Entity Name

GEORGIA DEPT OF PUBLIC HEALTH

Subdivision Name

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID303031

Entity Address

200 Piedmont Ave. SE
West Tower
Suite 1508
ATLANTA, GA 30334

Grant Number

X07HA22709

Participating Start Date

4/1/1997

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

HPB INC.

Pharmacy Address

BARNEY'S PHARMACY
2604 PEACH ORCHARD RD
AUGUSTA, GA 30906

Pharmacy Comments

Contract Details

Approval Date

10/6/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Marisol Cruz, HIV Care Program Manager
(404) 463-2453

Contract Pharmacy Representative

BARNEY'S PHARMACY
Vanessa Hoffman, Pharmacist
(706) 798-5645

Signed By Date

10/6/2016

340B Drug Pricing Program Database