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KOHLL'S RX
CH078170 Bluestem Health
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Covered Entity Details
Entity Name
Bluestem Health
Subdivision Name
Bluestem Health
Type
HRSA-Funded Health Center
340B ID
CH078170
Entity Address
1021 N 27th St
Lincoln, NE 68503-1803
Grant Number
H80CS00236
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KOHLL'S RX
Pharmacy Address
SAKRX, LLC
808 N 27TH ST
LINCOLN, NE 68503-2523
Pharmacy Comments
Contract Details
Approval Date
3/22/2019
Contract Begin Date
3/22/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brad Lee Meyer, Chief Executive Officer
(402) 470-5424
Contract Pharmacy Representative
Kohll's RX
David Kohll, President
(402) 895-6812
Signed By Date
3/22/2019
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