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PHARMBLUE TENNESSEE LLC
CH042440 FAMILY HEALTH CARE CLINIC, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CARE CLINIC, INC.
Subdivision Name
FAMILY HEALTH CARE CLINIC, INC.--PEARL
Type
HRSA-Funded Health Center
340B ID
CH042440
Entity Address
4635 Highway 80 E
Pearl, MS 39208-4226
Grant Number
H80CS00487
Participating Start Date
7/1/2007
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE TENNESSEE LLC
Pharmacy Address
1113 MURFREESBORO ROAD
SUITE 319B
FRANKLIN, TN 37064-1306
Pharmacy Comments
Contract Details
Approval Date
10/13/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2020
Ownership change
Contacts
Covered Entity Signing Official
MARGARET A. GRAY, PRESIDENT & CEO
(601) 825-7280 Ext: 5005
Contract Pharmacy Representative
PharmBlue, LLC
Joseph P. Pohl III, CEO
(724) 779-4720 Ext: 033
Signed By Date
10/13/2017
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