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EQUITAS HEALTH PHARMACY
CHC43215-00 LUTHERAN SOCIAL SERVICES OF CENTRAL OHIO
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Covered Entity Details
Entity Name
LUTHERAN SOCIAL SERVICES OF CENTRAL OHIO
Subdivision Name
Faith Mission
Type
HRSA-Funded Health Center
340B ID
CHC43215-00
Entity Address
245 N GRANT AVE
COLUMBUS, OH 43215-2641
Grant Number
H80CS30717
Participating Start Date
7/1/2017
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
EQUITAS HEALTH PHARMACY
Pharmacy Address
AMC OHIO LLC
1033 N. HIGH ST.
COLUMBUS, OH 43201
Pharmacy Comments
Contract Details
Approval Date
7/1/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Susan Villilo, AVP Community-Based Services
(614) 999-1102
Contract Pharmacy Representative
Equitas Health
Nick Saltman, Interim Chief Pharmacy Officer
(614) 987-5621
Signed By Date
7/1/2019
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