Contract Pharmacy Details

DISCOUNT DRUG MART #73
CHC12892-00 ROCKING HORSE CENTER

Covered Entity Details

Entity Name

ROCKING HORSE CENTER

Subdivision Name

Type

HRSA-Funded Health Center

340B ID

CHC12892-00

Entity Address

651 SOUTH LIMESTONE STREET
SPRINGFIELD, OH 45505

Grant Number

H80CS12892

Participating Start Date

7/1/2009

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

DISCOUNT DRUG MART #73

Pharmacy Address

7617 DAYTON-SPRINGFIELD RD
FAIRBORN, OH 45324

Pharmacy Comments

Contract Details

Approval Date

4/18/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2017
Agreement registered in error

Contacts

Covered Entity Signing Official

Kent Youngman, CEO
(937) 324-1111 Ext: 190

Contract Pharmacy Representative

Discount Drug Mart
Pete Ratycz, Vice President of Pharmacy
(330) 725-2340

Signed By Date

4/18/2017

340B Drug Pricing Program Database