Contract Pharmacy Details

FREDS 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

FREDS PHARMACY

Pharmacy Address

102 NORFLEET DRIVE
SENATOBIA, MS 38668

Pharmacy Comments

Contract Details

Approval Date

10/18/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2019
Pharmacy closed

Contacts

Covered Entity Signing Official

AURELIA JONES-TAYLOR, CEO
(662) 624-4292 Ext: 1119

Contract Pharmacy Representative

Fred's Pharmacy
Betty Ngo, Sr. Director 340B Program Operations
(901) 481-0346

Signed By Date

10/18/2016

340B Drug Pricing Program Database