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SCHNUCKS PHARMACY
CH059700 Central Counties Health Centers, Inc.
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Covered Entity Details
Entity Name
Central Counties Health Centers, Inc.
Subdivision Name
Capitol Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH059700
Entity Address
2239 E Cook St
Springfield, IL 62703-1944
Grant Number
H80CS00533
Participating Start Date
4/1/2000
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SCHNUCKS PHARMACY
Pharmacy Address
SCHNUCK MARKETS, INC.
1911 SANGAMON AVE E
SPRINGFIELD, IL 62702
Pharmacy Comments
Contract Details
Approval Date
7/1/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2017
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Brad Buzzard, COO
(217) 788-2325
Contract Pharmacy Representative
Schnuck's Pharmacy
David Chism, Director of Pharmacy
(314) 344-9636
Signed By Date
7/1/2015
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