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HERCHE BLOOR PHARMACY
CHC08238-00 CHANGE, INCORPORATED
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Covered Entity Details
Entity Name
CHANGE, INCORPORATED
Subdivision Name
Family Medical Care Community Health Center - Hancock County
Type
HRSA-Funded Health Center
340B ID
CHC08238-00
Entity Address
3136 West St
Weirton, WV 26062-4637
Grant Number
H80CS08238
Participating Start Date
4/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HERCHE BLOOR PHARMACY
Pharmacy Address
104 E 5TH ST
EAST LIVERPOOL, OH 43920
Pharmacy Comments
Contract Details
Approval Date
10/3/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Judy Raveaux, CEO
(304) 797-7733 Ext: 1311
Contract Pharmacy Representative
Herche Bloor
Bruno Decaria, Owner
(330) 385-0825
Signed By Date
10/3/2018
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