340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FRED MEYER PHARMACY #649
CH107930 KODIAK ISLAND HEALTH CARE FOUNDATION
Print
Covered Entity Details
Entity Name
KODIAK ISLAND HEALTH CARE FOUNDATION
Subdivision Name
KODIAK COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH107930
Entity Address
1911 E Rezanof Dr
Kodiak, AK 99615-6602
Grant Number
H80CS01445
Participating Start Date
4/1/2004
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
FRED MEYER PHARMACY #649
Pharmacy Address
535 E PALMER-WASILLA HWY
PALMER, AK 99645-6575
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/15/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Carol Austerman, Executive Director/CEO
(907) 481-5002
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
4/15/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session