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EXPRESS SCRIPTS
CHC26576-00 Dayton Health Center dba Five Rivers Health Centers
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Covered Entity Details
Entity Name
Dayton Health Center dba Five Rivers Health Centers
Subdivision Name
Five Rivers Health Centers Edgemont Campus
Type
HRSA-Funded Health Center
340B ID
CHC26576-00
Entity Address
721 Miami Chapel Road
Dayton, OH 45417
Grant Number
H80CS26576
Participating Start Date
7/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
EXPRESS SCRIPTS
Pharmacy Address
ESI MAIL PHARMACY SERVICE INC
4600 N HANLEY RD
SAINT LOUIS, MO 63134
Pharmacy Comments
Contract Details
Approval Date
7/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gina McFarlane-El, CEO
(937) 281-5940
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
7/12/2024
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