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REALO DISCOUNT DRUG STORES OF PINK HILL,
CH048120 KINSTON COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
KINSTON COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
KINSTON COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH048120
Entity Address
324 North Queen Street
Kinston, NC 28501-4932
Grant Number
H80CS00104
Participating Start Date
1/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
REALO DISCOUNT DRUG STORES OF PINK HILL,
Pharmacy Address
107 W BROADWAY ST
PINK HILL, NC 28572-7998
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/13/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
Mark Johnson, CEO
(252) 522-4350 Ext: 221
Contract Pharmacy Representative
Realo
Michael G. Wiggins, President
(252) 568-3161
Signed By Date
7/15/2015
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