Contract Pharmacy Details

SUP-RX PHARMACY #92
CHC08240-00 HopeHealth, Inc.

Covered Entity Details

Entity Name

HopeHealth, Inc.

Subdivision Name

HopeHealth Irby Street

Type

HRSA-Funded Health Center

340B ID

CHC08240-00

Entity Address

360 N Irby ST
Florence, SC 29501

Grant Number

H80CS08240

Participating Start Date

4/1/2013

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

SUP-RX PHARMACY #92

Pharmacy Address

1945 WEST PALMETTO STREET
SUITE 32
FLORENCE, SC 29501-3919

Pharmacy Comments

Contract Details

Approval Date

1/15/2014

Contract Begin Date

4/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/27/2018
Ownership change

Contacts

Covered Entity Signing Official

Carl Humphries, CEO
(843) 667-9414 Ext: 1500

Contract Pharmacy Representative

Robert Moody, RPH/MANAGER
(843) 673-9107

Signed By Date

1/15/2014