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KROGER PHARMACY #743
CH03099B Monroe County Health Department
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Covered Entity Details
Entity Name
Monroe County Health Department
Subdivision Name
MONROE HEALTH CENTER - FOREST HILL
Type
HRSA-Funded Health Center
340B ID
CH03099B
Entity Address
180 Old Schoolhouse Rd
Forest Hill, WV 24935
Grant Number
H80CS00384
Participating Start Date
4/1/2018
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #743
Pharmacy Address
308 STOKES DRIVE
HINTON, WV 25951
Pharmacy Comments
Contract Details
Approval Date
1/11/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jim Nelson, CEO
(304) 772-3064 Ext: 129
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/11/2021
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