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FRED MEYER
CH100160 COMMUNITY HEALTH CLINICS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CLINICS, INC.
Subdivision Name
TERRY REILLY HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH100160
Entity Address
211 16th Ave N
Nampa, ID 83687-4058
Grant Number
H80CS00636
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
FRED MEYER
Pharmacy Address
50 SECOND STREET SOUTH
NAMPA, ID 83651-3700
Pharmacy Comments
Contract Details
Approval Date
4/22/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heidi Hart, CEO
(208) 318-1255
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
4/22/2016
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