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KROGER PHARMACY CE 894
CHC02456-05 WINDROSE HEALTH NETWORK, INC.
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Covered Entity Details
Entity Name
WINDROSE HEALTH NETWORK, INC.
Subdivision Name
Windrose Health Network - Whiteland
Type
HRSA-Funded Health Center
340B ID
CHC02456-05
Entity Address
8 U.S. 31 North
Whiteland, IN 46184
Grant Number
H80CS02456
Participating Start Date
1/1/2018
Last Recertification Date
1/29/2020
Entity Termination Date
1/1/2021
Pharmacy Details
Pharmacy Name
KROGER PHARMACY CE 894
Pharmacy Address
8745 SOUTH EMERSON AVENUE
INDIANAPOLIS, IN 46237
Pharmacy Comments
Contract Details
Approval Date
4/1/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Scott K Rollett, CEO
(317) 739-4895 Ext: 2401
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
4/1/2019
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