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RINNE PHARMACY LLC
CHC26564-10 SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Subdivision Name
Four Rivers Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26564-10
Entity Address
509 E 10th St
Rolla, MO 65401-3302
Grant Number
H80CS26564
Participating Start Date
1/1/2024
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
RINNE PHARMACY LLC
Pharmacy Address
100 DEER LICK ST
LICKING, MO 65542
Pharmacy Comments
Contract Details
Approval Date
4/3/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stuart Hunter Gipson, CEO
(417) 576-7273
Contract Pharmacy Representative
Four Rivers Community Health Center
Angela M Brooks, Director of Pharmacy Services
(573) 545-5934
Signed By Date
4/3/2025
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