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CENTERWELL PHARMACY, INC.
CH101630 VALLEY FAMILY HEALTH CARE INC
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Covered Entity Details
Entity Name
VALLEY FAMILY HEALTH CARE INC
Subdivision Name
VALLEY FAMILY HEALTH CARE - Payette Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH101630
Entity Address
1441 NE 10th Ave
Payette, ID 83661-5420
Grant Number
H80CS00556
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CENTERWELL PHARMACY, INC.
Pharmacy Address
9843 WINDISCH RD
WEST CHESTER, OH 45069
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/10/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Timothy Heinze, CEO
(208) 642-7364
Contract Pharmacy Representative
Humana pharmacy, Inc.
Kristine Bryant, Senior 340B Channel Development Professional
(513) 672-5719
Signed By Date
1/15/2021
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