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KROGER PHARMACY N-512
CHC08238-00 CHANGE, INCORPORATED
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Covered Entity Details
Entity Name
CHANGE, INCORPORATED
Subdivision Name
Family Medical Care Community Health Center - Hancock County
Type
HRSA-Funded Health Center
340B ID
CHC08238-00
Entity Address
3136 West St
Weirton, WV 26062-4637
Grant Number
H80CS08238
Participating Start Date
4/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY N-512
Pharmacy Address
264 S HOLLYWOOD BLVD
STEUBENVILLE, OH 43952
Pharmacy Comments
Contract Details
Approval Date
7/13/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Mowry, CEO
(304) 797-7733 Ext: 1311
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/13/2022
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