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CLINICAL SOLUTIONS KANSAS, LLC
STD674391 Kansas Department of Corrections
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Covered Entity Details
Entity Name
Kansas Department of Corrections
Subdivision Name
Ellsworth Correctional Facility
Type
Sexually Transmitted Diseases
340B ID
STD674391
Entity Address
1607 State St.
Medical
Ellsworth, KS 67439
Grant Number
NH25PS005173
Participating Start Date
1/1/2023
Last Recertification Date
5/10/2024
Pharmacy Details
Pharmacy Name
CLINICAL SOLUTIONS KANSAS, LLC
Pharmacy Address
4615 N CYPRESS ST STE 150
BEL AIRE, KS 67226
Pharmacy Comments
Contract Details
Approval Date
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gerald Jorgenson, Director of Office of Health Care Compliance
(785) 207-1481
Contract Pharmacy Representative
Clinical Solutions, LLC
Christi Throneberry, CEO
(615) 369-2485
Signed By Date
7/11/2024
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