Contract Pharmacy Details

DILLONS PHARMACY #84
CHC24169-00 Health Ministries Clinic, Inc.

Covered Entity Details

Entity Name

Health Ministries Clinic, Inc.

Subdivision Name

Health Ministries Clinic Dental Office

Type

HRSA-Funded Health Center

340B ID

CHC24169-00

Entity Address

805 Medical Center Dr.
Newton, KS 67114

Grant Number

H80CS24169

Participating Start Date

1/1/2014

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

DILLONS PHARMACY #84

Pharmacy Address

1216 NORTH MAIN
NEWTON, KS 67114

Pharmacy Comments

Contract Details

Approval Date

4/15/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Matthew Schmidt, Chief Executive Officer
(316) 281-7314

Contract Pharmacy Representative

Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672

Signed By Date

4/15/2014

340B Drug Pricing Program Database