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RIVER MEDICAL PHARMACY LLC
CH040760 G.A. CARMICHAEL FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
G.A. CARMICHAEL FAMILY HEALTH CENTER, INC.
Subdivision Name
G. A. CARMICHAEL FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH040760
Entity Address
1668 W Peace St
Canton, MS 39046-5332
Grant Number
H80CS00484
Participating Start Date
10/1/2013
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/29/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James L. Coleman Jr., CEO
(601) 859-5213 Ext: 2291
Contract Pharmacy Representative
Bioplusrx
Kristen Van Orman, Senior Regional Director of Sales
(407) 280-6647
Signed By Date
4/13/2018
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