Contract Pharmacy Details

HILS PHARMACY
CH075300 FAMILY HEALTH CENTER OF BOONE COUNTY

Covered Entity Details

Entity Name

FAMILY HEALTH CENTER OF BOONE COUNTY

Subdivision Name

Type

HRSA-Funded Health Center

340B ID

CH075300

Entity Address

1001 W. WORLEY
COLUMBIA, MO 65203-2037

Grant Number

H80CS00573

Participating Start Date

7/1/2000

Last Recertification Date

1/28/2020

Entity Termination Date

1/1/2021

Pharmacy Details

Pharmacy Name

HILS PHARMACY

Pharmacy Address

HILS, LLC
800 N MORLEY ST
MOBERLY, MO 65270

Pharmacy Comments

Contract Details

Approval Date

7/14/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2021
Covered Entity Terminated

Contacts

Covered Entity Signing Official

GLORIA L. CRULL, CEO
(573) 886-6713

Contract Pharmacy Representative

Hils Pharmacy
Ann Hils, Owner
(660) 263-4457

Signed By Date

7/14/2017