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IC PHARMACY LLC
CHC08753-00 BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
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Covered Entity Details
Entity Name
BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
Subdivision Name
Hamilton Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC08753-00
Entity Address
210 South Second Street
Hamilton, OH 45011
Grant Number
H80CS08753
Participating Start Date
4/1/2006
Last Recertification Date
2/21/2025
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
10/11/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen Joseph Roller, President & CEO
(513) 454-1467
Contract Pharmacy Representative
PillPack by Amazon Pharmacy
John Lavin, Vice President
(714) 380-0579
Signed By Date
10/11/2024
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