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AVELLA OF ST LOUIS
CH046150 AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.
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Covered Entity Details
Entity Name
AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC.
Subdivision Name
AARON E. HENRY - CLARKSDALE CLINIC
Type
HRSA-Funded Health Center
340B ID
CH046150
Entity Address
800 Ohio Ave
Clarksdale, MS 38614-7200
Grant Number
H80CS00480
Participating Start Date
7/1/1998
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
AVELLA OF ST LOUIS
Pharmacy Address
450 N NEW BALLAS RD STE 256
SAINT LOUIS, MO 63141-6836
Pharmacy Comments
Contract Details
Approval Date
4/9/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
AURELIA JONES-TAYLOR, CEO
(662) 624-4292 Ext: 1119
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
4/9/2018
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