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FRIENDLY PHARMACY
CHC26514-01 TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
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Covered Entity Details
Entity Name
TRIAD ADULT AND PEDIATRIC MEDICINE, INC.
Subdivision Name
TAPM Family Medicine at Eugene
Type
HRSA-Funded Health Center
340B ID
CHC26514-01
Entity Address
1002 S Eugene St
Greensboro, NC 27406-1308
Grant Number
H80CS26514
Participating Start Date
1/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
FRIENDLY PHARMACY
Pharmacy Address
3712 LAWNDALE DR STE G
GREENSBORO, NC 27455-3066
Pharmacy Comments
Contract Details
Approval Date
4/4/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michelle Lewis, CEO
(336) 355-9715
Contract Pharmacy Representative
Hayley Dunn, Pharmacy Manager
(336) 790-7343
Signed By Date
4/4/2016
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