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KROGER PHARMACY L-396
CHC28353-00 LifeSpring Inc.
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Covered Entity Details
Entity Name
LifeSpring Inc.
Subdivision Name
LifeSpring Community Medical Services
Type
HRSA-Funded Health Center
340B ID
CHC28353-00
Entity Address
1036 SHARON DR
JEFFERSONVILLE, IN 47130-4522
Grant Number
H80CS28353
Participating Start Date
10/1/2015
Last Recertification Date
3/12/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY L-396
Pharmacy Address
200 NEW ALBANY PLAZA
NEW ALBANY, IN 47150
Pharmacy Comments
Contract Details
Approval Date
10/9/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Beth Keeney, President/CEO
(812) 206-1362
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/9/2019
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