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DILLON'S PHARMACY #54
CAH171384-00 NEWMAN MEMORIAL COUNTY HOSPITAL
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Covered Entity Details
Entity Name
NEWMAN MEMORIAL COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171384-00
Entity Address
1201 W. 12th Ave.
EMPORIA, KS 66801
Medicare Provider Number
171384
Participating Start Date
1/1/2016
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
DILLON'S PHARMACY #54
Pharmacy Address
800 NW 25TH STREET
TOPEKA, KS 66618
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Holly R. French, CFO
(620) 343-6800 Ext: 22610
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
1/15/2025
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