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ZIKS FAMILY PHARMACY, INC #100
CHC26576-00 Dayton Health Center dba Five Rivers Health Centers
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Covered Entity Details
Entity Name
Dayton Health Center dba Five Rivers Health Centers
Subdivision Name
Five Rivers Health Centers Edgemont Campus
Type
HRSA-Funded Health Center
340B ID
CHC26576-00
Entity Address
721 Miami Chapel Road
Dayton, OH 45417
Grant Number
H80CS26576
Participating Start Date
7/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
ZIKS FAMILY PHARMACY, INC #100
Pharmacy Address
1130 W 3RD ST,
DAYTON, OH 45402
Pharmacy Comments
Contract Details
Approval Date
1/26/2023
Contract Begin Date
2/6/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diane M. Cummins, Chief Operating Officer
(937) 281-5942
Contract Pharmacy Representative
Ziks Family Pharmacy
Nnodum Iheme, Owner
(937) 225-9350
Signed By Date
1/26/2023
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