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DILLON PHARMACY #87
CHC24108-00 HEALTH PARTNERSHIP CLINIC INC
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Covered Entity Details
Entity Name
HEALTH PARTNERSHIP CLINIC INC
Subdivision Name
Health Partnership Clinic, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC24108-00
Entity Address
407 S Clairborne Rd
STE 104
Olathe, KS 66062
Grant Number
H80CS24108
Participating Start Date
10/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
DILLON PHARMACY #87
Pharmacy Address
5311 SW 22ND PLACE
TOPEKA, KS 66614
Pharmacy Comments
Contract Details
Approval Date
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/6/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Amy Falk, CEO
(913) 648-2266
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/18/2017
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