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PIGGLY WIGGLY PHARMACY #48
CHC08240-05 HopeHealth, Inc.
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Covered Entity Details
Entity Name
HopeHealth, Inc.
Subdivision Name
HopeHealth Lake City School-based Health Center
Type
HRSA-Funded Health Center
340B ID
CHC08240-05
Entity Address
652 N. Matthews Rd.
Lake City, SC 29560
Grant Number
H80CS08240
Participating Start Date
7/1/2013
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
PIGGLY WIGGLY PHARMACY #48
Pharmacy Address
269 NORTH RON MCNAIR BOULEVARD
LAKE CITY, SC 29560
Pharmacy Comments
10/25/2010 - ADDRESS CHANGED FROM 212 WEST MAIN STREET.
Contract Details
Approval Date
10/8/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Carl Humphries, CEO
(843) 667-9414 Ext: 1500
Contract Pharmacy Representative
SPENCER PLAYER, OWNER
(843) 394-3121
Signed By Date
10/8/2013
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