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AMC OHIO LLC #2
RWII43201 Equitas Health, Inc.
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Covered Entity Details
Entity Name
Equitas Health, Inc.
Subdivision Name
Equitas Health Short North
Type
Ryan White Part B
340B ID
RWII43201
Entity Address
1033 NORTH HIGH STREET
COLUMBUS, OH 43201
Grant Number
X07HA00016
Participating Start Date
1/1/2013
Last Recertification Date
2/8/2021
Entity Termination Date
7/1/2021
Pharmacy Details
Pharmacy Name
AMC OHIO LLC #2
Pharmacy Address
1222 S. PATTERSON BLVD
SUITE 110
DAYTON, OH 45402-2645
Pharmacy Comments
Contract Details
Approval Date
4/7/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Peggy Anderson, Chief Operating Officer
(614) 340-6691
Contract Pharmacy Representative
Aaron Clark, Director of Pharmacy Services
(614) 340-6776
Signed By Date
4/7/2014
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