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KROGER
CH051831A HEART OF OHIO FAMILY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEART OF OHIO FAMILY HEALTH CENTERS
Subdivision Name
Capital Park Family Health Center at Innis Road
Type
HRSA-Funded Health Center
340B ID
CH051831A
Entity Address
2365 Innis Rd
Columbus, OH 43224-3730
Grant Number
H80CS07897
Participating Start Date
7/1/2014
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
KROGER
Pharmacy Address
3675 E BROAD STREET
WHITEHALL, OH 43213
Pharmacy Comments
Contract Details
Approval Date
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
M Buhari Mohammed, CEO
(614) 338-6818 Ext: 1118
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/14/2020
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