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HY-VEE, INC.
CH0712430 Infinity Health
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Covered Entity Details
Entity Name
Infinity Health
Subdivision Name
Infinity Health
Type
HRSA-Funded Health Center
340B ID
CH0712430
Entity Address
302 NE 14th St
Leon, IA 50144-1206
Grant Number
H80CS04200
Participating Start Date
9/9/2005
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
HY-VEE, INC.
Pharmacy Address
DBA: HY-VEE CLINIC PHARMACY (1389)
204 N MAIN ST.
LEON, IA 50144
Pharmacy Comments
Contract Details
Approval Date
4/14/2014
Contract Begin Date
4/14/2014
Carve-In Effective Date
Contract Comments
04/14/2014 Contract begin date adjustment, immediate begin date authorized
Contacts
Covered Entity Signing Official
Samantha Cannon, Chief Executive Officer
(641) 446-2383 Ext: 1250
Contract Pharmacy Representative
Hy- Vee
BOB EGELAND, VP PHARMACY OPERATIONS
(515) 267-2800
Signed By Date
4/14/2014
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