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MANSFIELD DRUG CO, INC
CHC26579-00 C A S S E DENTAL HEALTH INSTITUTE
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Covered Entity Details
Entity Name
C A S S E DENTAL HEALTH INSTITUTE
Subdivision Name
CASSE/Community Health Institute
Type
HRSA-Funded Health Center
340B ID
CHC26579-00
Entity Address
907 POLK STREET
MANSFIELD, LA 71052
Grant Number
H80CS26579
Participating Start Date
7/1/2018
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
MANSFIELD DRUG CO, INC
Pharmacy Address
132 JEFFERSON ST
MANSFIELD, LA 71052-2602
Pharmacy Comments
Contract Details
Approval Date
7/16/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Beth Chumley, CEO
(318) 688-3350
Contract Pharmacy Representative
Helen Ducote, Owner
(318) 872-1933
Signed By Date
7/16/2015
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