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THE PHARMACY II, LLC
CH07720A ADVOCATES FOR A HEALTHY COMMUNITY INC
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Covered Entity Details
Entity Name
ADVOCATES FOR A HEALTHY COMMUNITY INC
Subdivision Name
Jordan Valley Community Health Center - Tampa
Type
HRSA-Funded Health Center
340B ID
CH07720A
Entity Address
440 E Tampa St
Springfield, MO 65806-1131
Grant Number
H80CS00275
Participating Start Date
10/1/2003
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
THE PHARMACY II, LLC
Pharmacy Address
DBA ORCHARD HILLS PHARMACY
3816A W CHESTNUT EXPY
SPRINGFIELD, MO 65802
Pharmacy Comments
Contract Details
Approval Date
10/11/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Kruger, VP PACE/Pharmacy
(417) 851-1551
Contract Pharmacy Representative
The Pharmacy II, LLC
Colby Grove, Managing Member
(417) 868-8288
Signed By Date
10/11/2024
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