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SINKS PHARMACY SOUTH
CHC26564-00 South Central Missouri Community Health Center
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Covered Entity Details
Entity Name
South Central Missouri Community Health Center
Subdivision Name
South Central Missouri Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26564-00
Entity Address
1050 W 10th Street,Suite 480
Rolla, MO 65401
Grant Number
H80CS26564
Participating Start Date
10/1/2014
Last Recertification Date
2/14/2018
Entity Termination Date
7/1/2018
Pharmacy Details
Pharmacy Name
SINKS PHARMACY SOUTH
Pharmacy Address
1100B S BISHOP AVE
ROLLA, MO 65401-4418
Pharmacy Comments
Contract Details
Approval Date
7/5/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kelly Miller, Interim CEO/CFO
(573) 426-6714
Contract Pharmacy Representative
Medley Pharmacy, Inc.
Sandy Mitchell, President
(573) 259-2910
Signed By Date
7/5/2017
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