340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KROGER PHARMACY
CH050040 SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION
Print
Covered Entity Details
Entity Name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION
Subdivision Name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT C
Type
HRSA-Funded Health Center
340B ID
CH050040
Entity Address
109 California St
Carterville, IL 62918-1923
Grant Number
H80CS00667
Participating Start Date
7/1/1998
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY
Pharmacy Address
1609 SOUTH PARK AVENUE
HERRIN, IL 62948
Pharmacy Comments
Contract Details
Approval Date
11/14/2012
Contract Begin Date
11/14/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patsy R. Jensen, CEO
(618) 985-8221
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
9/28/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session