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KROGER PHARMACY #409
CHC09959-01 GRACE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GRACE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Grace Health Manchester
Type
HRSA-Funded Health Center
340B ID
CHC09959-01
Entity Address
85 Highway 80
Manchester, KY 40962-1401
Grant Number
H80CS09959
Participating Start Date
10/1/2010
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #409
Pharmacy Address
1732 WEST HWY 192
LONDON, KY 40741
Pharmacy Comments
Contract Details
Approval Date
4/7/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael W Stanley, Chief Executive Officer
(606) 526-9005
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
4/7/2023
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