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KENTUCKY CENTRAL FILL FACILITY, L-010
CH052180 RURAL HEALTH, INC.
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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
KENTUCKY CENTRAL FILL FACILITY, L-010
Pharmacy Address
5594 SHEPHERDSVILLE ROAD
LOUISVILLE, KY 40228-1012
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
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
1/7/2016
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