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CLEVELAND DRUG CO INC
CH040390 MEDLINK GEORGIA, INC.
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Covered Entity Details
Entity Name
MEDLINK GEORGIA, INC.
Subdivision Name
Medlink Colbert
Type
HRSA-Funded Health Center
340B ID
CH040390
Entity Address
11 CHARLIE MORRIS RD
COLBERT, GA 30628
Grant Number
H80CS00427
Participating Start Date
7/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CLEVELAND DRUG CO INC
Pharmacy Address
DBA CLEVELAND DRUG CO
184 W KYTLE ST STE A
CLEVELAND, GA 30528
Pharmacy Comments
Contract Details
Approval Date
10/12/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dave Ward, CEO
(706) 788-3234
Contract Pharmacy Representative
Cleveland Drug Co., Inc.
Ray Black, Owner/PIC
(706) 219-2626
Signed By Date
10/12/2017
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