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KROGER PHARMACY
CH051780 NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.
Subdivision Name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO
Type
HRSA-Funded Health Center
340B ID
CH051780
Entity Address
313 Jefferson Ave
Toledo, OH 43604-1004
Grant Number
H80CS00110
Participating Start Date
12/1/1992
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY
Pharmacy Address
4925 JACKMAN ROAD
TOLEDO, OH 43613
Pharmacy Comments
Contract Details
Approval Date
10/15/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DONI MILLER, CEO
(419) 720-7883 Ext: 216
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
10/15/2015
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