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IC PHARMACY LLC
CH051831A HEART OF OHIO FAMILY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEART OF OHIO FAMILY HEALTH CENTERS
Subdivision Name
Capital Park Family Health Center at Innis Road
Type
HRSA-Funded Health Center
340B ID
CH051831A
Entity Address
2365 Innis Rd
Columbus, OH 43224-3730
Grant Number
H80CS07897
Participating Start Date
7/1/2014
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
IC PHARMACY LLC
Pharmacy Address
AMAZON PHARMACY #004
34 35TH STREET
STE 4BSW, UNIT 28
BROOKLYN, NY 11232
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
M Buhari Mohammed, CEO
(614) 338-6818 Ext: 1118
Contract Pharmacy Representative
Heart of Ohio Family Health
Alexandra Zeleski, Director of Pharmacy
(614) 235-5555 Ext: 1136
Signed By Date
7/15/2024
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