340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LOOKOUT MOUNTAIN COMMUNITY
CH044790 PRIMARY HEALTH CARE CENTER OF DADE, INC.
Print
Covered Entity Details
Entity Name
PRIMARY HEALTH CARE CENTER OF DADE, INC.
Subdivision Name
PRIMARY HEALTH CARE CENTER TRENTON
Type
HRSA-Funded Health Center
340B ID
CH044790
Entity Address
13570 N Main St
Trenton, GA 30752-2012
Grant Number
H80CS00649
Participating Start Date
1/1/1998
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
LOOKOUT MOUNTAIN COMMUNITY
Pharmacy Address
SERVICES
1875 FANT DRIVE
FORT OGLETHORPE, GA 30742
Pharmacy Comments
Contract Details
Approval Date
7/9/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/12/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DIANA U. ALLEN, CEO
(706) 657-7575 Ext: 217
Contract Pharmacy Representative
Daisy Cameron, Pharmacy Manager
(706) 861-3387 Ext: 1135
Signed By Date
7/9/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session