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SUMMERVILLE PHARMACY
CHC24172-00 CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
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Covered Entity Details
Entity Name
CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
Subdivision Name
Christ Community Health: Medical District CHC
Type
HRSA-Funded Health Center
340B ID
CHC24172-00
Entity Address
1226 Dantignac St
Augusta, GA 30901-2788
Grant Number
H80CS24172
Participating Start Date
7/1/2013
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
SUMMERVILLE PHARMACY
Pharmacy Address
2839 CENTRAL AVENUE
AUGUSTA, GA 30909
Pharmacy Comments
Contract Details
Approval Date
4/15/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/15/2017
Pharmacy closed
Contacts
Covered Entity Signing Official
Thomas J. Drake III, Executive Director
(706) 922-3017
Contract Pharmacy Representative
Rob Woods, Pharmacist/Owner
(706) 481-7140
Signed By Date
4/15/2015
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