340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
GIANT EAGLE PHARMACY #4016
CHC33659-01 My Community Health Center
Print
Covered Entity Details
Entity Name
My Community Health Center
Subdivision Name
My Community Health Center - Magnolia
Type
HRSA-Funded Health Center
340B ID
CHC33659-01
Entity Address
10029 Cleveland Ave. S
Magnolia, OH 44643-9781
Grant Number
H80CS33659
Participating Start Date
4/1/2020
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
GIANT EAGLE PHARMACY #4016
Pharmacy Address
11031 STATE RT 212, NE
BOLIVAR, OH 44612
Pharmacy Comments
Contract Details
Approval Date
4/28/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Juan Paulo Afable, CEO
(502) 509-8987
Contract Pharmacy Representative
Giant Eagle
Stacey Tierney, Pharmacy District Manager
(330) 874-3511
Signed By Date
4/28/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session