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COMMONS CORNER APOTHECARY
CH046840 FAMILY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS, INC.
Subdivision Name
FAMILY HEALTH CENTERS, INC./FAMILY HEALTH CENTER - PORTLAND
Type
HRSA-Funded Health Center
340B ID
CH046840
Entity Address
2215 Portland Ave
Attn:Pharmacy
Louisville, KY 40212-1033
Grant Number
H80CS00102
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
COMMONS CORNER APOTHECARY
Pharmacy Address
9407 NORTON COMMONS BLVD
PROSPECT, KY 40059-4020
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/28/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
BILL B WAGNER, CEO
(502) 778-4201
Contract Pharmacy Representative
Efill Rx
Robert Warford, Director of Pharmacy
(502) 554-3436
Signed By Date
10/14/2019
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