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GIANT EAGLE PHARMACY #0221
CHC12886-00 LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
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Covered Entity Details
Entity Name
LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
Subdivision Name
Lower Lights Christian Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12886-00
Entity Address
1160 W Broad St
Columbus, OH 43222-1317
Grant Number
H80CS12886
Participating Start Date
1/1/2011
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GIANT EAGLE PHARMACY #0221
Pharmacy Address
20160 CENTER RIDGE ROAD, SUITE 201
ROCKY RIVER, OH 44116
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
Tracy Cloud, CEO
(614) 274-1455 Ext: 6000
Contract Pharmacy Representative
Giant Eagle, Inc.
Mike Bianco, Senior Pharmacy Manager
(412) 967-3718
Signed By Date
4/15/2020
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