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PROFESSIONAL PHARMACY
FP275652 GRANVILLE VANCE DIST HEALTH DEPT
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Covered Entity Details
Entity Name
GRANVILLE VANCE DIST HEALTH DEPT
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP275652
Entity Address
1032 COLLEGE STREET
OXFORD, NC 27565
Grant Number
5FPHPA006555-03-00
Participating Start Date
1/1/1998
Last Recertification Date
5/22/2024
Pharmacy Details
Pharmacy Name
PROFESSIONAL PHARMACY
Pharmacy Address
140 ROXBORO RD.
OXFORD, NC 27565
Pharmacy Comments
Contract Details
Approval Date
7/12/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Harrison, Health Director
(919) 693-2141
Contract Pharmacy Representative
Professional Pharmacy
Gary Bowman, Pharmacist
(919) 693-8555
Signed By Date
7/12/2013
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