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EVANS DRUG SEDALIA WEST LLC
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
EVANS DRUG SEDALIA WEST LLC
Pharmacy Address
1400 S LIMIT AVE, SUITE 3
SEDALIA, MO 65301
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Michael Waller, CEO
(208) 800-8676
Contract Pharmacy Representative
Evans Drugs
Kevin McCullough, Owner
(417) 876-3313
Signed By Date
1/11/2024
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