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ST. LOUIS PHARMACY
CH071700 FAMILY CARE HEALTH CENTERS
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Covered Entity Details
Entity Name
FAMILY CARE HEALTH CENTERS
Subdivision Name
CARONDELET
Type
HRSA-Funded Health Center
340B ID
CH071700
Entity Address
401 HOLLY HILLS AVE
ST LOUIS, MO 63111-2410
Grant Number
H80CS00492
Participating Start Date
10/1/2002
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
ST. LOUIS PHARMACY
Pharmacy Address
4245 FOREST PARK AVE STE B
SAINT LOUIS, MO 63108-2810
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert K. Massie, CEO
(314) 481-1615 Ext: 1315
Contract Pharmacy Representative
West Pine Pharmacy
Devin Dalpoas, President
(314) 533-1081
Signed By Date
10/15/2020
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