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HCC PHARMACY-DME
CHC30712-00 COMMUNITY HEALTH INTERVENTIONS & SICKLE CELL AGENCY, INCORPORATED
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Covered Entity Details
Entity Name
COMMUNITY HEALTH INTERVENTIONS & SICKLE CELL AGENCY, INCORPORATED
Subdivision Name
South Central Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC30712-00
Entity Address
102 West Southern Avenue
Raeford, NC 28376-3218
Grant Number
H80CS30712
Participating Start Date
7/1/2018
Last Recertification Date
2/1/2019
Entity Termination Date
10/1/2019
Pharmacy Details
Pharmacy Name
HCC PHARMACY-DME
Pharmacy Address
HCC PHARMACY INC
402 S MAIN ST
RAEFORD, NC 28376
Pharmacy Comments
Contract Details
Approval Date
4/19/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Delvin McAllister, CEO
(910) 488-6118
Contract Pharmacy Representative
HCC Pharmacy
David Oxendine, Pharmacist
(910) 848-0630
Signed By Date
4/9/2018
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