Contract Pharmacy Details

KROGER PHARMACY L672
CH052180 RURAL HEALTH, INC.

Covered Entity Details

Entity Name

RURAL HEALTH, INC.

Subdivision Name

ANNA MEDICAL CLINIC

Type

HRSA-Funded Health Center

340B ID

CH052180

Entity Address

513 NORTH MAIN STREET
ANNA, IL 62906

Grant Number

H80CS00711

Participating Start Date

10/1/1998

Last Recertification Date

2/17/2025

Pharmacy Details

Pharmacy Name

KROGER PHARMACY L672

Pharmacy Address

45 PLAZA DR
ANNA, IL 62906-2034

Pharmacy Comments

Contract Details

Approval Date

1/7/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Cindy Flamm, CEO
(618) 833-4471 Ext: 1015

Contract Pharmacy Representative

Signed By Date

1/7/2016