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ECKERD CORPORATION
CH045630 GASTON FAMILY HEALTH SERVICES INC
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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
ECKERD CORPORATION
Pharmacy Address
RITE AID #11439
520 EAST TRADE STREET
DALLAS, NC 28034
Pharmacy Comments
Contract Details
Approval Date
10/1/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/5/2018
Ownership change
Contacts
Covered Entity Signing Official
Robert Spencer, CEO
(704) 616-2245
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
10/1/2013
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