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PARKSIDE PHARMACY
CH057480 RIGGS COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
RIGGS COMMUNITY HEALTH CENTER, INC.
Subdivision Name
RIGGS COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH057480
Entity Address
1716 Hartford St
Lafayette, IN 47904-2173
Grant Number
H80CS00565
Participating Start Date
1/1/1997
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PARKSIDE PHARMACY
Pharmacy Address
1639 N LEBANON ST
LEBANON, IN 46052
Pharmacy Comments
Contract Details
Approval Date
10/5/2022
Contract Begin Date
11/7/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Dowell, CFO
(765) 429-2770
Contract Pharmacy Representative
Cowan Drugs
john Cowan, President
(765) 482-0180
Signed By Date
10/5/2022
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