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KROGER PHARMACY #531
CH051833A Heartland Community Health Clinic DBA: Heartland Health Services
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Covered Entity Details
Entity Name
Heartland Community Health Clinic DBA: Heartland Health Services
Subdivision Name
Garden
Type
HRSA-Funded Health Center
340B ID
CH051833A
Entity Address
1701 W Garden St
Peoria, IL 61605
Grant Number
H80CS02457
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #531
Pharmacy Address
1405 W. GARFIELD
BARTONVILLE, IL 61607
Pharmacy Comments
Contract Details
Approval Date
1/6/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sharon Adams, Chief Executive Officer
(309) 680-7657
Contract Pharmacy Representative
RxStrategies
Jordan Hytken, Senior Account Executive
(954) 602-0052
Signed By Date
1/6/2022
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