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WHITE CROSS PHARMACY INC
CHC08784-00 LAKES COMMUNITY HEALTH CENTER, INC., THE
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Covered Entity Details
Entity Name
LAKES COMMUNITY HEALTH CENTER, INC., THE
Subdivision Name
NorthLakes - Iron River
Type
HRSA-Funded Health Center
340B ID
CHC08784-00
Entity Address
7665 Us Highway 2
Iron River, WI 54847-4690
Grant Number
H80CS08784
Participating Start Date
7/1/2010
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WHITE CROSS PHARMACY INC
Pharmacy Address
314 SILVER ST
HURLEY, WI 54534-1254
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Akl, COO
(715) 372-5001
Contract Pharmacy Representative
Shell Lake Pharmacy
Josh Prohaska, CEO
(715) 415-1891
Signed By Date
4/17/2023
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