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PHARMALOOP LLC
CH07170F FAMILY CARE HEALTH CENTERS
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Covered Entity Details
Entity Name
FAMILY CARE HEALTH CENTERS
Subdivision Name
FOREST PARK SOUTHEAST
Type
HRSA-Funded Health Center
340B ID
CH07170F
Entity Address
4352 MANCHESTER AVE
ST. LOUIS, MO 63110-2138
Grant Number
H80CS00492
Participating Start Date
7/1/2014
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
PHARMALOOP LLC
Pharmacy Address
VAN'S DELIVERY PHARMACY
3229 LEMAY FERRY RD
SAINT LOUIS, MO 63125-4419
Pharmacy Comments
Contract Details
Approval Date
7/18/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aramide Ayorinde, Chief Executive Officer
(314) 481-1615 Ext: 1315
Contract Pharmacy Representative
Vans Delivery Pharmacy
Alex Pirogovsky, Owner
(314) 200-6500
Signed By Date
7/18/2024
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