Contract Pharmacy Details

KROGER PHARMACY #864
CHC02456-04 WINDROSE HEALTH NETWORK, INC.

Covered Entity Details

Entity Name

WINDROSE HEALTH NETWORK, INC.

Subdivision Name

Windrose Health Network - Epler Parke

Type

HRSA-Funded Health Center

340B ID

CHC02456-04

Entity Address

5550 S EAST ST
INDIANAPOLIS, IN 46227-1979

Grant Number

H80CS02456

Participating Start Date

10/1/2016

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

KROGER PHARMACY #864

Pharmacy Address

2200 INDEPENDENCE DRIVE
GREENWOOD, IN 46143

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

7/13/2024
Business decision by covered entity and/or pharmacy

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

340B Drug Pricing Program Database