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KROGER PHARMACY N-598
CH05847D COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
PrimaryOne Health 2300 West Broad Street
Type
HRSA-Funded Health Center
340B ID
CH05847D
Entity Address
2300 W Broad St
Columbus, OH 43204-3783
Grant Number
H80CS00118
Participating Start Date
4/1/1999
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY N-598
Pharmacy Address
3600 SOLDANO BLVD
COLUMBUS, OH 43228
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charleta B. Tavares, CEO
(614) 859-1880
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/13/2023
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