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GIANT EAGLE PHARMACY #6517
CH05847H COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
PrimaryOne Health 1500 East 17th Avenue
Type
HRSA-Funded Health Center
340B ID
CH05847H
Entity Address
1500 E 17th Ave
Columbus, OH 43219-1002
Grant Number
H80CS00118
Participating Start Date
4/1/1999
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
GIANT EAGLE PHARMACY #6517
Pharmacy Address
2900 STELZER ROAD
COLUMBUS, OH 43219
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
GIANT EAGLE
Mike Bianco, President & CEO
(412) 967-3718
Signed By Date
10/13/2023
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