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HY-VEE PHARMACY #1056
CH0718570 Eastern Iowa Health Center
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Covered Entity Details
Entity Name
Eastern Iowa Health Center
Subdivision Name
Eastern Iowa Health Center
Type
HRSA-Funded Health Center
340B ID
CH0718570
Entity Address
1201 3rd Ave SE
Cedar Rapids, IA 52403
Grant Number
H80CS08226
Participating Start Date
4/1/2008
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HY-VEE PHARMACY #1056
Pharmacy Address
20 WILSON AVENUE SW
CEDAR RAPIDS, IA 52404
Pharmacy Comments
Contract Details
Approval Date
7/16/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/24/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Lock, President & CEO
(319) 730-7300
Contract Pharmacy Representative
Hy-Vee
Ashley Plum, 340B Coordinator
(515) 559-5708
Signed By Date
7/16/2019
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