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BOGARD DRUGS INC #5
CH051833G Heartland Community Health Clinic DBA: Heartland Health Services
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Covered Entity Details
Entity Name
Heartland Community Health Clinic DBA: Heartland Health Services
Subdivision Name
East Bluff
Type
HRSA-Funded Health Center
340B ID
CH051833G
Entity Address
2321 N Wisconsin Ave
Peoria, IL 61603
Grant Number
H80CS02457
Participating Start Date
7/1/2007
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
BOGARD DRUGS INC #5
Pharmacy Address
1102 S WESTERN AVE
PEORIA, IL 61605
Pharmacy Comments
Contract Details
Approval Date
4/9/2010
Contract Begin Date
4/9/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/25/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
4/1/2010
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