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KROGER PHARMACY #014948
CHC25682-03 CHRISTIAN COMMUNITY HEALTH SERVICES
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Covered Entity Details
Entity Name
CHRISTIAN COMMUNITY HEALTH SERVICES
Subdivision Name
Crossroad Health Center - Taft
Type
HRSA-Funded Health Center
340B ID
CHC25682-03
Entity Address
270 Southern Avenue
Cincinnati, OH 45219-3023
Grant Number
H80CS25682
Participating Start Date
7/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #014948
Pharmacy Address
6165 GLENWAY AVENUE
CINCINNATI, OH 45211
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
James Joseph Berrens, CEO
(513) 707-5755
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
4/15/2020
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