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HUTCHINSON DRUG STORE
CHC08239-00 PRAIRIESTAR HEALTH CENTER INC
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Covered Entity Details
Entity Name
PRAIRIESTAR HEALTH CENTER INC
Subdivision Name
PRAIRIESTAR HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC08239-00
Entity Address
2700 E 30TH AVE
HUTCHINSON, KS 67502
Grant Number
H80CS08239
Participating Start Date
4/1/2012
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
HUTCHINSON DRUG STORE
Pharmacy Address
703 E 30TH AVE.
HUTCHINSON, KS 67502-4406
Pharmacy Comments
Contract Details
Approval Date
4/14/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/13/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Bryant Anderson, Chief Executive Officer
(620) 802-0035
Contract Pharmacy Representative
Hutchinson Drug Store
Aaron Hirst, Manager
(620) 669-6699
Signed By Date
4/14/2018
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