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GROVE PROFESSIONAL PHARMACY
FQHCLA444 Aids Project Of The Ozarks
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Covered Entity Details
Entity Name
Aids Project Of The Ozarks
Subdivision Name
AIDS Project of the Ozarks
Type
Health Center Program Look-Alike
340B ID
FQHCLA444
Entity Address
1636 S Glenstone Ave Ste 100
Springfield, MO 65804-1527
Grant Number
LALCS47457
Participating Start Date
4/1/2023
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
GROVE PROFESSIONAL PHARMACY
Pharmacy Address
STORE #1
3050 S. NATIONAL AVE, STE 109
SPRINGFIELD, MO 65804
Pharmacy Comments
Contract Details
Approval Date
2/9/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LYNNE L. MEYERKORD, EXECUTIVE DIRECTOR
(417) 881-1900
Contract Pharmacy Representative
Grove Professional Pharmacies, Inc
Belinda Browining, General Manager
(417) 881-2910 Ext: 501
Signed By Date
1/11/2023
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