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GIANT EAGLE PHARMACY #4056
CH056440 OHIO NORTH EAST HEALTH SYSTEMS INC
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Covered Entity Details
Entity Name
OHIO NORTH EAST HEALTH SYSTEMS INC
Subdivision Name
Youngstown Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH056440
Entity Address
726 Wick Ave
Youngstown, OH 44505-2827
Grant Number
H80CS00196
Participating Start Date
4/1/1999
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
GIANT EAGLE PHARMACY #4056
Pharmacy Address
2700 MAHONING AVE N.W.
WARREN, OH 44483
Pharmacy Comments
Contract Details
Approval Date
4/12/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ronald Dwinnells, CEO
(330) 747-2330
Contract Pharmacy Representative
Giant Eagle, Inc.
Mike Bianco, Senior Pharmacy Manager
(412) 967-3718
Signed By Date
4/12/2019
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