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Hy-Vee Pharmacy Fulfillment Center #4016
CHC08748-06 COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI
Subdivision Name
Community Health Center of Central Missouri - Christy Drive
Type
HRSA-Funded Health Center
340B ID
CHC08748-06
Entity Address
1511 Christy Drive
Jefferson City, MO 65101-2854
Grant Number
H80CS08748
Participating Start Date
7/1/2018
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
Hy-Vee Pharmacy Fulfillment Center #4016
Pharmacy Address
Hy-Vee Inc
4707 Fleur Dr
Des Moines, IA 50321
Pharmacy Comments
Contract Details
Approval Date
10/10/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/19/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Toby Barnett, CFO
(573) 632-0243
Contract Pharmacy Representative
Hy Vee
Ashley Plum, 340b Coordinator
(515) 267-2800
Signed By Date
10/10/2019
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