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WAL-MART PHARMACY 10-2098
CH051831C HEART OF OHIO FAMILY HEALTH CENTERS
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Covered Entity Details
Entity Name
HEART OF OHIO FAMILY HEALTH CENTERS
Subdivision Name
Heart of Ohio Family Health at James B. Feibel Center
Type
HRSA-Funded Health Center
340B ID
CH051831C
Entity Address
5000 E. Main Street
Columbus, OH 43213-2440
Grant Number
H80CS07897
Participating Start Date
7/1/2014
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2098
Pharmacy Address
3900 MORSE RD
COLUMBUS, OH 43219
Pharmacy Comments
Contract Details
Approval Date
4/19/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/28/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Marlene Miller, CEO
(614) 338-6818
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/19/2017
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