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THE KROGER CO., KS 113
CH0818490 SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Southwest Utah Community Health Center dba Family Healthcare
Type
HRSA-Funded Health Center
340B ID
CH0818490
Entity Address
2276 E Riverside Drive
Saint George, UT 84790
Grant Number
H80CS07890
Participating Start Date
4/1/2008
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
THE KROGER CO., KS 113
Pharmacy Address
1220 S. LIPAN STREET
DENVER, CO 80223
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/15/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lori Wright, CEO
(435) 879-5101
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/13/2020
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