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KROGER PHARMACY
CH052900 COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
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Covered Entity Details
Entity Name
COMMUNITY ACTION COMMITTEE OF PIKE COUNTY
Subdivision Name
N/A
Type
HRSA-Funded Health Center
340B ID
CH052900
Entity Address
941 MARKET STREET
PIKETON, OH 45661
Grant Number
H80CS00399
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY
Pharmacy Address
530 E. MAIN STREET
JACKSON, OH 45640
Pharmacy Comments
Contract Details
Approval Date
4/15/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary B. Roberts, Executive Director
(740) 289-2371
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
4/15/2014
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