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KROGER PHARMACY
CHC33907-01 Bluegrass Primary Health Care Center, Inc.
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Covered Entity Details
Entity Name
Bluegrass Primary Health Care Center, Inc.
Subdivision Name
DBA Bluegrass Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC33907-01
Entity Address
1306 Versailles Rd Ste 120
Lexington, KY 40504-1795
Grant Number
H80CS33907
Participating Start Date
4/1/2020
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY
Pharmacy Address
1808 ALEXANDRIA DR
LEXINGTON, KY 40504
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alan S Wrightson, MD
(859) 977-7472
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
4/15/2021
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