Contract Pharmacy Details

DILLON PHARMACY #87
CHC24108-05 HEALTH PARTNERSHIP CLINIC, INC.

Covered Entity Details

Entity Name

HEALTH PARTNERSHIP CLINIC, INC.

Subdivision Name

Health Partnership Clinic, Inc.

Type

HRSA-Funded Health Center

340B ID

CHC24108-05

Entity Address

107 South Main Street
Ottawa, KS 66067

Grant Number

H80CS24108

Participating Start Date

10/1/2017

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

7/17/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/1/2024
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

7/17/2017

340B Drug Pricing Program Database