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KROGER COLUMBUS CENTRAL FILL #019
CH0530920 HEALTHLINC INC
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Covered Entity Details
Entity Name
HEALTHLINC INC
Subdivision Name
HealthLinc Valparaiso
Type
HRSA-Funded Health Center
340B ID
CH0530920
Entity Address
1001 Sturdy Rd
Valparaiso, IN 46383-4126
Grant Number
H80CS06662
Participating Start Date
1/1/2004
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
KROGER COLUMBUS CENTRAL FILL #019
Pharmacy Address
2270 RICKENBACKER PKWY W
COLUMBUS, OH 43217
Pharmacy Comments
Contract Details
Approval Date
7/20/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BETH WROBEL, CEO
(219) 465-9500
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/20/2020
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