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OVERLAKE PHARMACY, LLC
CH0612200 HEALTHY CONNECTIONS INC
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Covered Entity Details
Entity Name
HEALTHY CONNECTIONS INC
Subdivision Name
Healthy Connections, Inc.
Type
HRSA-Funded Health Center
340B ID
CH0612200
Entity Address
136 Health Park Ln.
Mena, AR 71953-4280
Grant Number
H80CS00279
Participating Start Date
1/1/2007
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
OVERLAKE PHARMACY, LLC
Pharmacy Address
4124 148TH AVE NE STE JA
REDMOND, WA 98052
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tony Calandro, CEO
(479) 437-3449 Ext: 181
Contract Pharmacy Representative
Truepill
Jason Anderson, Director, Business Development
(650) 353-5495
Signed By Date
10/15/2021
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