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COLE CAMP PHARMACY
CH0714960 REGIONAL HEALTH CARE CLINIC, INC.
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Covered Entity Details
Entity Name
REGIONAL HEALTH CARE CLINIC, INC.
Subdivision Name
REGIONAL HEALTH CARE CLINIC, INC., dba Katy Trail Community Health
Type
HRSA-Funded Health Center
340B ID
CH0714960
Entity Address
821 Westwood Dr
Sedalia, MO 65301-2102
Grant Number
H80CS06668
Participating Start Date
11/7/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
COLE CAMP PHARMACY
Pharmacy Address
512 W. MAIN ST.
PO BOX 100
COLE CAMP, MO 65325
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Waller, CEO
(208) 800-8676
Contract Pharmacy Representative
Cole Camp Pharmacy
Mike Snell, Owner
(660) 668-4646
Signed By Date
1/11/2024
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