Contract Pharmacy Details

MEDICAP PHARMACY
CH046150 AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.

Covered Entity Details

Entity Name

AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.

Subdivision Name

AARON E. HENRY - CLARKSDALE CLINIC

Type

HRSA-Funded Health Center

340B ID

CH046150

Entity Address

800 Ohio Ave
Clarksdale, MS 38614-7200

Grant Number

H80CS00480

Participating Start Date

7/1/1998

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

MEDICAP PHARMACY

Pharmacy Address

110 HIGHWAY 51 N
BATESVILLE, MS 38606-2347

Pharmacy Comments

Contract Details

Approval Date

11/20/2003

Contract Begin Date

11/20/2003

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/14/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

340B Drug Pricing Program Database