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KROGER PHARMACY N-299
CH058470 COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
COLUMBUS NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
CNHC dba PrimaryOne Health
Type
HRSA-Funded Health Center
340B ID
CH058470
Entity Address
2780 Airport Drive, Suite 100
Columbus, OH 43219-1060
Grant Number
H80CS00118
Participating Start Date
10/1/1998
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY N-299
Pharmacy Address
4485 REFUGEE RD
COLUMBUS, OH 43232
Pharmacy Comments
Contract Details
Approval Date
10/17/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/19/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Charleta B. Tavares, CEO
(614) 859-1946
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
10/17/2016
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