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ENGLEKING RX MARENGO, LLC
CHC33650-01 SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC
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Covered Entity Details
Entity Name
SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC
Subdivision Name
SICHC English
Type
HRSA-Funded Health Center
340B ID
CHC33650-01
Entity Address
307 S. Indiana Ave.
English, IN 47118
Grant Number
H80CS33650
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
ENGLEKING RX MARENGO, LLC
Pharmacy Address
D/B/A ENGLEKING RX
125 W OLD SHORT ST
MARENGO, IN 47140
Pharmacy Comments
Contract Details
Approval Date
1/11/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Nancy Radcliff, CEO
(812) 723-3944
Contract Pharmacy Representative
Engleking Rx, LLC
Ryan Engleking, Pharmacist/ Owner
(812) 865-3266
Signed By Date
1/11/2022
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