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THE KROGER CO., KS 113
CAH171383-00 William Newton Memorial Hospital
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Covered Entity Details
Entity Name
William Newton Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171383-00
Entity Address
1300 E. 5th
Winfield, KS 67156-2495
Medicare Provider Number
171383
Participating Start Date
10/29/2013
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
THE KROGER CO., KS 113
Pharmacy Address
1220 S. LIPAN STREET
DENVER, CO 80223
Pharmacy Comments
Contract Details
Approval Date
4/13/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/26/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeffery Benjamin Quinton, CEO
(620) 221-2300 Ext: 101
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
4/13/2020
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