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Hy-Vee Pharmacy Fulfillment Center #4016
CH078170 Bluestem Health
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Covered Entity Details
Entity Name
Bluestem Health
Subdivision Name
Bluestem Health
Type
HRSA-Funded Health Center
340B ID
CH078170
Entity Address
1021 N 27th St
Lincoln, NE 68503-1803
Grant Number
H80CS00236
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
Hy-Vee Pharmacy Fulfillment Center #4016
Pharmacy Address
Hy-Vee Inc
4707 Fleur Dr
Des Moines, IA 50321
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brad Lee Meyer, Chief Executive Officer
(402) 470-5424
Contract Pharmacy Representative
Hy-vee Inc.
Marshall Sanders, 340B Program Manager
(515) 267-6009
Signed By Date
4/15/2020
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