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FOUR STATES APOTHECARY DBA CJ PHARMACY
CH077570 COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, INC.
Subdivision Name
COMMUNITY HEALTH CENTER OF SOUTHEAST KS
Type
HRSA-Funded Health Center
340B ID
CH077570
Entity Address
3011 N Michigan St
Pittsburg, KS 66762-2546
Grant Number
H80CS00841
Participating Start Date
1/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
FOUR STATES APOTHECARY DBA CJ PHARMACY
Pharmacy Address
102 S MAIN ST
CARL JUNCTION, MO 64834-1000
Pharmacy Comments
Contract Details
Approval Date
1/4/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KRISTA POSTAI, CEO
(620) 235-1867
Contract Pharmacy Representative
Wolkar Drug
Brian Caswell, Owner
(620) 856-3176
Signed By Date
1/4/2021
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