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KROGER PHARMACY
CHC10584-00 CENTER STREET COMMUNITY C
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Covered Entity Details
Entity Name
CENTER STREET COMMUNITY C
Subdivision Name
Center Street Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC10584-00
Entity Address
136 W Center St
Marion, OH 43302-3704
Grant Number
H80CS10584
Participating Start Date
7/1/2009
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY
Pharmacy Address
1608 MARION MT GILEAD
MARION, OH 43302
Pharmacy Comments
Contract Details
Approval Date
2/1/2010
Contract Begin Date
2/1/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CLIFF EDWARDS, CEO
(740) 751-6380
Contract Pharmacy Representative
WILLIAM F. SHERRIDAN II, PHARMACY MERCHANDISER
(614) 898-3542
Signed By Date
12/16/2009
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