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PILLPACK LLC
CH041110 FETTER HEALTHCARE NETWORK INC.
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Covered Entity Details
Entity Name
FETTER HEALTHCARE NETWORK INC.
Subdivision Name
FRANKLIN C FETTER FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH041110
Entity Address
51 Nassau St
Charleston, SC 29403-5513
Grant Number
H80CS09088
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
PILLPACK LLC
Pharmacy Address
DBA PILLPACK BY AMAZON PHARMACY
250 COMMERCIAL ST STE 2012
MANCHESTER, NH 03101
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aretha Jones, CEO
(843) 722-4112 Ext: 3004
Contract Pharmacy Representative
Fetter Health Care Network
Deborah Stivender Brooker, Pharmacy Coordinator
(843) 720-5655
Signed By Date
4/16/2018
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