Contract Pharmacy Details

SMITH'S
CH045630 GASTON FAMILY HEALTH SERVICES INC

Covered Entity Details

Entity Name

GASTON FAMILY HEALTH SERVICES INC

Subdivision Name

Kintegra Family Medicine - Hudson

Type

HRSA-Funded Health Center

340B ID

CH045630

Entity Address

991 W Hudson Blvd
Gastonia, NC 28052-6430

Grant Number

H80CS00293

Participating Start Date

10/1/1997

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

SMITH'S

Pharmacy Address

121-125 WEST MAIN STREET
GASTONIA, NC 28052

Pharmacy Comments

Contract Details

Approval Date

7/11/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/23/2016
Pharmacy closed

Contacts

Covered Entity Signing Official

Robert Spencer, CEO
(704) 616-2245

Contract Pharmacy Representative

Arnold Walker, Owner
(704) 865-2354

Signed By Date

7/11/2013