Contract Pharmacy Details

HART PHARMACY INC
CHC08772-03 GRACEMED HEALTH CLINIC, INC.

Covered Entity Details

Entity Name

GRACEMED HEALTH CLINIC, INC.

Subdivision Name

GraceMed Downing Family Clinic

Type

HRSA-Funded Health Center

340B ID

CHC08772-03

Entity Address

2201 E 25th St N, Bldg 200
Wichita, KS 67219-4701

Grant Number

H80CS08772

Participating Start Date

10/1/2009

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

HART PHARMACY INC

Pharmacy Address

6217 E 13TH STREET N
WICHITA, KS 67208-2654

Pharmacy Comments

Contract Details

Approval Date

11/12/2009

Contract Begin Date

11/12/2009

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/10/2020
OPA Terminated due to audit finding

Contacts

Covered Entity Signing Official

DAVID C. SANFORD, CEO
(316) 494-2001

Contract Pharmacy Representative

Signed By Date

9/19/2009