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SVANDA PHARMACY
CHC26562-03 Heartland Health Center, Inc.
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Covered Entity Details
Entity Name
Heartland Health Center, Inc.
Subdivision Name
Heartland Health Center - Ravenna Clinic
Type
HRSA-Funded Health Center
340B ID
CHC26562-03
Entity Address
104 W Seneca St
Ravenna, NE 68869-1363
Grant Number
H80CS26562
Participating Start Date
10/1/2020
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
SVANDA PHARMACY
Pharmacy Address
314 GRAND AVE
RAVENNA, NE 68869-1322
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tami Smith, CEO
(308) 675-4223
Contract Pharmacy Representative
Svanda Pharmacy
Geoff Wright, Pharmacist
(308) 452-3672
Signed By Date
10/16/2023
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