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JAYHAWK PHARMACY WEST
CHC24170-05 Heartland Medical Clinic, Incorporated
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Covered Entity Details
Entity Name
Heartland Medical Clinic, Incorporated
Subdivision Name
Heartland at Panda Pediatrics
Type
HRSA-Funded Health Center
340B ID
CHC24170-05
Entity Address
1803 W 6th St
Lawrence, KS 66044-1710
Grant Number
H80CS24170
Participating Start Date
4/1/2021
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
JAYHAWK PHARMACY WEST
Pharmacy Address
6265 ROCK CHALK DR STE 1401
LAWRENCE, KS 66049-5232
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Julie Boden Schmidt, Chief Executive Officer
(785) 841-7297
Contract Pharmacy Representative
Jayhawk Pharmacy
Erick Axcell, Owner
(785) 843-0111
Signed By Date
7/15/2021
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