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NRS PHARMACIES OF INDIANA LLC
FQHCLA393A Neighborhood Health Center, INC
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Covered Entity Details
Entity Name
Neighborhood Health Center, INC
Subdivision Name
Neighborhood Health Center - Union County Medical Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA393A
Entity Address
950 N Market St
Liberty, IN 47353-8496
Grant Number
LALCS32717
Participating Start Date
4/1/2020
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
NRS PHARMACIES OF INDIANA LLC
Pharmacy Address
DBA MEDICENTER ALTERNATE CARE PHARMACY
100 W MAIN ST
CAMBRIDGE CITY, IN 47327
Pharmacy Comments
Contract Details
Approval Date
1/16/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carrie N Miles, CEO
(765) 965-4299
Contract Pharmacy Representative
EDS MEDICENTER PHARMACY
Steve Sommer, Manager Contracting & Channel Management
(618) 826-2511
Signed By Date
1/13/2020
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