340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KROGER SPECIALTY PHARMACY TX
SCH450010-00 United Regional Health Care System
Print
Covered Entity Details
Entity Name
United Regional Health Care System
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH450010-00
Entity Address
1600 11th Street
Wichita Falls, TX 76301
Medicare Provider Number
450010
Participating Start Date
1/1/2013
Last Recertification Date
9/14/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
KROGER SPECIALTY PHARMACY TX
Pharmacy Address
4280 KELLWAY CIR
ADDISON, TX 75001-4200
Pharmacy Comments
Contract Details
Approval Date
1/6/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/30/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Robert M. Pert, Chief Financial Officer
(940) 764-3023
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/6/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session