Contract Pharmacy Details

KROGER PHARMACY #796
CH05166D IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION

Covered Entity Details

Entity Name

IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION

Subdivision Name

Ironton Health Care Campus

Type

HRSA-Funded Health Center

340B ID

CH05166D

Entity Address

1408 Campbell Dr
Ironton, OH 45638-2301

Grant Number

H80CS00471

Participating Start Date

4/1/2012

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

KROGER PHARMACY #796

Pharmacy Address

370 DIEDRICH BLVD.
GREENUP MALL
ASHLAND, KY 41101

Pharmacy Comments

Contract Details

Approval Date

4/14/2020

Contract Begin Date

5/6/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kelly Adkins, Chief Financial Officer
(740) 532-3534 Ext: 12004

Contract Pharmacy Representative

Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875

Signed By Date

4/14/2020

340B Drug Pricing Program Database