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KROGER PHARMACY #770
CHC11332-00 COMMUNITY HEALTH CENTERS OF GREATER DAYTON
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF GREATER DAYTON
Subdivision Name
Community Health Centers of Greater Dayton - Charles Drew Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11332-00
Entity Address
1323 W. 3rd St.
Dayton, OH 45402-6714
Grant Number
H80CS12882
Participating Start Date
10/1/2009
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #770
Pharmacy Address
255 N. HEINCKE RD.
MIAMISBURG, OH 45342
Pharmacy Comments
Contract Details
Approval Date
4/19/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GREGORY HOPKINS, EXECUTIVE DIRECTOR
(937) 586-9733 Ext: 1023
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
4/19/2017
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