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CORNER PHARMACY LLC
CHC33657-01 Highland Health Providers Corporation
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Covered Entity Details
Entity Name
Highland Health Providers Corporation
Subdivision Name
Highland Health Providers - Rocky Fork Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC33657-01
Entity Address
11130 N Shore Dr
Hillsboro, OH 45133
Grant Number
H80CS33657
Participating Start Date
4/1/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CORNER PHARMACY LLC
Pharmacy Address
259 JEFFERSON ST
GREENFIELD, OH 45123
Pharmacy Comments
Contract Details
Approval Date
2/27/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Meghann Ackley, Chief Financial Officer
(937) 840-6617
Contract Pharmacy Representative
Corner Pharmacy
Eric Zint, President
(937) 981-2454
Signed By Date
2/27/2020
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