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PRIME THERAPEUTICS SPECIALTY PHARMACY LL
CH051831A HEART OF OHIO FAMILY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEART OF OHIO FAMILY HEALTH CENTERS
Subdivision Name
Capital Park Family Health Center at Innis Road
Type
HRSA-Funded Health Center
340B ID
CH051831A
Entity Address
2365 Innis Rd
Columbus, OH 43224-3730
Grant Number
H80CS07897
Participating Start Date
7/1/2014
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
PRIME THERAPEUTICS SPECIALTY PHARMACY LL
Pharmacy Address
ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992
Pharmacy Comments
Contract Details
Approval Date
7/21/2022
Contract Begin Date
7/21/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
M Buhari Mohammed, CEO
(614) 338-6818 Ext: 1118
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/21/2022
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