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AMC OHIO LLC
HV43212 EQUITAS HEALTH
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Covered Entity Details
Entity Name
EQUITAS HEALTH
Subdivision Name
Type
Ryan White Part C
340B ID
HV43212
Entity Address
4400 NORTH HIGH STREET
SUITE 300
COLUMBUS, OH 43214
Grant Number
H76HA00531
Participating Start Date
4/1/2000
Last Recertification Date
2/23/2023
Entity Termination Date
7/1/2023
Pharmacy Details
Pharmacy Name
AMC OHIO LLC
Pharmacy Address
1033 N. HIGH STREET
COLUMBUS, OH 43201-2409
Pharmacy Comments
Contract Details
Approval Date
10/10/2012
Contract Begin Date
10/10/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Peggy Anderson, Chief Operating Officer
(614) 340-6691
Contract Pharmacy Representative
Equitas Health
Peggy Anderson, Chief Operating Officer
(614) 340-6691
Signed By Date
8/24/2012
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