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SMITHS FOOD & DRUG CTRS
CH086120 COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
Subdivision Name
Community Health Center of Central Wyoming
Type
HRSA-Funded Health Center
340B ID
CH086120
Entity Address
5000 Blackmore Road
Casper, WY 82609
Grant Number
H80CS00564
Participating Start Date
1/1/2001
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
SMITHS FOOD & DRUG CTRS
Pharmacy Address
SMITH'S FOOD & DRUG #185
2405 C-Y AVENUE
CASPER, WY 82604-1141
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cole White, CEO
(307) 233-6000
Contract Pharmacy Representative
Krogers
Anastacia Frey, Senior Manager
(513) 698-1875
Signed By Date
1/15/2019
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