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NORCROSS PHARMACY
STD30309 Positive Impact Health Centers, Inc.
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Covered Entity Details
Entity Name
Positive Impact Health Centers, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD30309
Entity Address
523 Church St
Decatur, GA 30030
Grant Number
NH25PS005244-01-00
Participating Start Date
10/1/2013
Last Recertification Date
5/6/2025
Pharmacy Details
Pharmacy Name
NORCROSS PHARMACY
Pharmacy Address
2625 BEAVER RUIN RD
NORCROSS, GA 30071-4136
Pharmacy Comments
Contract Details
Approval Date
7/14/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Danny Sprouse, Associate Director - Prevention
(678) 365-4300 Ext: 102
Contract Pharmacy Representative
Gerri Hankla, Pharmacist
(770) 448-2288
Signed By Date
7/14/2017
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