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CANNON PHARMACY MAIN
CH044523C CABARRUS COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
CABARRUS COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
China Grove Family Medicine
Type
HRSA-Funded Health Center
340B ID
CH044523C
Entity Address
307 East Thom Street
China Grove, NC 28023
Grant Number
H80CS06652
Participating Start Date
4/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CANNON PHARMACY MAIN
Pharmacy Address
1706 S CANNON BLVD
KANNAPOLIS, NC 28083
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/12/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Kim Wagenaar, CEO
(704) 792-2203
Contract Pharmacy Representative
Cannon Pharmacy
Arpit Bhatt, Owner/President
(704) 933-6337
Signed By Date
1/12/2018
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