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HILS PHARMACY
CH07530L Family Health Center of Boone County
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Covered Entity Details
Entity Name
Family Health Center of Boone County
Subdivision Name
Family Health Center Moberly
Type
HRSA-Funded Health Center
340B ID
CH07530L
Entity Address
1319 E Highway 24 Ste B
Moberly, MO 65270-3682
Grant Number
H80CS00573
Participating Start Date
7/1/2020
Last Recertification Date
Entity Termination Date
1/1/2021
Pharmacy Details
Pharmacy Name
HILS PHARMACY
Pharmacy Address
HILS, LLC
800 N MORLEY ST
MOBERLY, MO 65270
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jack Kelly, Chief Executive Officer
(573) 886-6713
Contract Pharmacy Representative
Hils Pharmacy
Ann Hils, Owner
(660) 263-4457
Signed By Date
4/15/2020
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