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HOUCHENS EXPRESS PHARMACY LLC
CH0421240 FAIRVIEW COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
FAIRVIEW COMMUNITY HEALTH CENTER
Subdivision Name
DBA FAIRVIEW COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0421240
Entity Address
225 NATCHEZ TRACE AVE
BOWLING GREEN, KY 42103-7995
Grant Number
H80CS00856
Participating Start Date
10/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HOUCHENS EXPRESS PHARMACY LLC
Pharmacy Address
DBA SHELDON'S EXPRESS PHARMACY
843 FAIRVIEW AVE STE A1
BOWLING GREEN, KY 42101-4914
Pharmacy Comments
03/10/2010 - NAME AND ADDRESS CHANGED FROM NATION'S MEDICINE, 830 FAIRVIEW AVE.
Contract Details
Approval Date
1/2/2002
Contract Begin Date
1/2/2002
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CHRIS KEYSER, EXECUTIVE DIRECTOR
(270) 783-4251
Contract Pharmacy Representative
Signed By Date
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