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THE KROGER CO
CHC08221-00 HEART CITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
HEART CITY HEALTH CENTER, INC.
Subdivision Name
HEART CITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC08221-00
Entity Address
236 Simpson Ave
Elkhart, IN 46516-4671
Grant Number
H80CS08221
Participating Start Date
4/1/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
THE KROGER CO
Pharmacy Address
DBA KROGER SAV #915
901 JOHNSON STREET
ELKHART, IN 46514
Pharmacy Comments
Contract Details
Approval Date
7/17/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Esleen Emma Fultz, CEO
(574) 970-3257
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/17/2019
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