Covered Entity Details

CH081849F Southwest Utah Community Health Center, Inc. (Active) - information as of 6/24/2025 3:09:28 AM

Main Details

Name

Southwest Utah Community Health Center, Inc.

Subdivision Name

Family Healthcare Zion Canyon Clinic

Type

HRSA-Funded Health Center

Site ID

BPS-H80-037302

340B ID

CH081849F

Grant Number

H80CS07890

Additional Details

Current Program Status

Active

Registration Date

1/12/2024

Participating Start Date

4/1/2024

Participating Approval Date

3/11/2024

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Southwest Utah Community Health Center
Lori Wright, CEO
(435) 879-5101

Primary Contact

Southwest Utah Community Health Center, Inc.
Kevin Jones, Pharmacist
(435) 879-5101

Addresses

Street Address

120 Lion Blvd
Springdale, UT 84767-7724

Billing Address

Southwest Utah Community Health Center DBA Family Healthcare
2276 E Riverside Dr.
St. George, UT 84790

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
UT		1477333417,1346986908

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	CEDAR DRUG AND GIFT, INC	755 S MAIN ST STE 7		CEDAR CITY	UT	84720	10/09/2024	01/01/2025	01/01/2025
Contract Detail	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	10/09/2024	01/01/2025	01/01/2025
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/09/2024	01/01/2025	01/01/2025
Contract Detail	WAL-MART PHARMACY 10-1438	1330 SOUTH PROVIDENCE CTR DR.		CEDAR CITY	UT	84720	10/09/2024	01/01/2025	01/01/2025
Contract Detail	WAL-MART PHARMACY 10-1439	625 W. TELEGRAPH STREET		WASHINGTON	UT	84780	10/09/2024	01/01/2025	01/01/2025
Contract Detail	WAL-MART PHARMACY 10-3220	2610 SOUTH PIONEER ROAD		ST GEORGE	UT	84790	10/09/2024	01/01/2025	01/01/2025
Contract Detail	WAL-MART PHARMACY 10-4678	180 NORTH 3400 WEST		HURRICANE	UT	84737	10/09/2024	01/01/2025	01/01/2025
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/09/2024	01/01/2025	01/01/2025
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/09/2024	01/01/2025	01/01/2025
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/09/2024	01/01/2025	01/01/2025

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH0818490	Active	BPS-H80-034392	SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.	Southwest Utah Community Health Center dba Family Healthcare	2276 E Riverside Drive	Saint George	UT
CH081849A	Terminated	BPS-H80-008178	SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.	Millcreek High Health Center dba Family Healthcare	2410 E Riverside Dr	Saint George	UT
CH081849B	Terminated	BPS-H80-009408	SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.	Cedar City Community Clinic dba Family Healthcare	74 W Harding Ave	Cedar City	UT
CH081849C	Active	BPS-H80-013925	SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.	Hurricane Utah School Based Clinic	391 N 200 W	Hurricane	UT
CH081849D	Active	BPS-H80-014975	SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.	Family Healthcare Cedar East	245 E 680 S	CEDAR CITY	UT
CH081849E	Active	BPS-H80-027275	SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC.	Family Healthcare Integrated Clinic	74 W Harding Ave	Cedar City	UT
CH081849F	Active	BPS-H80-037302	Southwest Utah Community Health Center, Inc.	Family Healthcare Zion Canyon Clinic	120 Lion Blvd	Springdale	UT
CH081849G	Active	BPS-H80-034798	Southwest Utah Community Health Center, Inc.	Family Healthcare Mobile Unit 1	2276 E Riverside Dr	Saint George	UT

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH0818490	CEDAR DRUG AND GIFT, INC	755 S MAIN ST STE 7		CEDAR CITY	UT	84720	07/01/2020
CH081849D	CEDAR DRUG AND GIFT, INC	755 S MAIN ST STE 7		CEDAR CITY	UT	84720	04/01/2023
CH081849C	CEDAR DRUG AND GIFT, INC	755 S MAIN ST STE 7		CEDAR CITY	UT	84720	04/01/2023
CH081849E	CEDAR DRUG AND GIFT, INC	755 S MAIN ST STE 7		CEDAR CITY	UT	84720	04/01/2023
CH081849F	CEDAR DRUG AND GIFT, INC	755 S MAIN ST STE 7		CEDAR CITY	UT	84720	01/01/2025
CH0818490	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/01/2020	08/15/2021
CH0818490	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	07/01/2014
CH081849A	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	07/01/2014	01/01/2023
CH081849B	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	07/01/2014	04/01/2018
CH081849C	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	10/01/2014
CH081849D	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	04/01/2023
CH081849E	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	04/01/2023
CH081849F	HURRICANE FAMILY PHARMACY	25 N 2000 W		HURRICANE	UT	84737	01/01/2025
CH0818490	KENTUCKY CENTRAL FILL FACILITY, L-010	5594 SHEPHERDSVILLE ROAD		LOUISVILLE	KY	40228-1012	04/01/2020	08/15/2021
CH0818490	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	04/01/2020	08/15/2021
CH0818490	SMITH MANAGEMENT CORP	DBA SMITH'S PHARMACY #69	1174 WEST 600 NORTH	SALT LAKE CITY	UT	84116	01/01/2014	01/10/2022
CH0818490	SMITH'S DRUG #44	DBA SMITHS FOOD KING #1	876 E 8TH S	SALT LAKE CITY	UT	84102	01/01/2014	01/10/2022
CH0818490	SMITH'S FOOD & DRUG #72	1725 UINTA WAY		PARK CITY	UT	84098	01/01/2014	01/06/2016
CH0818490	SMITH'S FOOD & DRUG CENTERS	DBA: SMITH'S PHARMACY #80	828 SOUTH 900 WEST	SALT LAKE CITY	UT	84104	01/01/2014	01/10/2022
CH0818490	SMITH'S FOOD & DRUG CENTERS	SMITH'S PHARMACY # 85	980 EAST FORT UNION BLVD.	MIDVALE	UT	84047	01/01/2014	01/10/2022
CH0818490	SMITH'S FOOD & DRUG CTR	SMITH'S FOOD & DRUG #144	45 SOUTH STATE	OREM	UT	84057	01/01/2014	01/10/2022
CH0818490	SMITH'S FOOD & DRUG CTR	SMITH'S FOOD & DRUG #140	2353 NORTH MAIN	SUNSET	UT	84015	01/01/2014	01/06/2016
CH0818490	SMITH'S FOOD & DRUG CTRS	SMITH'S FOOD & DRUG #138	1634 WEST SOUTH JORDAN PKWY	SOUTH JORDAN	UT	84095	01/01/2014	01/06/2016
CH0818490	SMITH'S FOOD AND DRUG CENTERS INC	SMITH'S PHARMACY 82	1080 WEST HIGHWAY 40	VERNAL	UT	84078	04/01/2016	01/10/2022
CH0818490	SMITH'S FOOD KING NO 1	SMITH'S DRUG KING PHARMACY #30	4275 HARRISON BLVD	OGDEN	UT	84403	01/01/2014	01/10/2022
CH0818490	SMITH'S MANAGEMENT CORP	DBA SMITH'S FOOD & DRUG #189	20 NORTH BLUFF ST	ST GEORGE	UT	84770	04/01/2008	11/30/2022
CH081849E	SMITH'S MANAGEMENT CORP	DBA SMITH'S FOOD & DRUG #189	20 NORTH BLUFF ST	ST GEORGE	UT	84770	01/01/2025
CH0818490	SMITH'S MANAGEMENT CORP	DBA SMITH'S FOOD & DRUG #189	20 NORTH BLUFF ST	ST GEORGE	UT	84770	01/01/2025
CH081849C	SMITH'S MANAGEMENT CORP	DBA SMITH'S FOOD & DRUG #189	20 NORTH BLUFF ST	ST GEORGE	UT	84770	01/01/2025
CH081849D	SMITH'S MANAGEMENT CORP	DBA SMITH'S FOOD & DRUG #189	20 NORTH BLUFF ST	ST GEORGE	UT	84770	01/01/2025
CH0818490	SMITH'S MANAGEMENT CORP DBA	SMITH'S FOOD & DRUG #66	PHARMACY 4065 SOUTH REDWOOD ROAD	SALT LAKE CITY	UT	84123	01/01/2014	01/10/2022
CH0818490	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	01/01/2014	11/30/2022
CH081849B	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	07/01/2010	04/01/2018
CH081849D	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	07/01/2018	12/01/2022
CH081849C	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	01/01/2025
CH081849E	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	01/01/2025
CH0818490	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	01/01/2025
CH081849D	SMITH'S PHARMACY	SMITH'S FOOD & DRUG #42	633 S. MAIN	CEDAR CITY	UT	84720	01/01/2025
CH0818490	SMITH'S PHARMACY #278	565 S MALL DR.		ST. GEORGE	UT	84790-1258	10/01/2017	11/30/2022
CH081849D	SMITH'S PHARMACY #278	565 S MALL DR.		ST. GEORGE	UT	84790-1258	01/01/2025
CH0818490	SMITH'S PHARMACY #278	565 S MALL DR.		ST. GEORGE	UT	84790-1258	01/01/2025
CH081849E	SMITH'S PHARMACY #278	565 S MALL DR.		ST. GEORGE	UT	84790-1258	01/01/2025
CH081849C	SMITH'S PHARMACY #278	565 S MALL DR.		ST. GEORGE	UT	84790-1258	01/01/2025
CH0818490	SMITH'S PHARMACY #28	922 E. 2100 S.		SALT LAKE CITY	UT	84106	01/01/2014	01/10/2022
CH0818490	SMITH'S PHARMACY #444	555 S. 200 W.		BOUNTIFUL	UT	84010	01/01/2014	01/06/2016
CH0818490	SMITH'S PHARMACY #444	555 S. 200 W.		BOUNTIFUL	UT	84010	07/01/2016	01/10/2022
CH0818490	SMITH'S PHARMACY #477	750 N. MAIN ST.		LOGAN	UT	84321	04/01/2016	01/10/2022
CH0818490	SMITH'S PHARMACY #87	442 N 175 E		LOGAN	UT	84321	01/01/2014	01/10/2022
CH0818490	SMITH'S PHARMACY #94	455 SOUTH 500 EAST		SALT LAKE CITY	UT	84102	01/01/2014	01/10/2022
CH0818490	SMITHS FOOD & DRUG #142	951 WEST 1700 SOUTH		SYRACUSE	UT	84075	01/01/2014	01/06/2016
CH0818490	SMITHS FOOD & DRUG CTR INC	SMITH'S PHARMACY #147	5620 W 4100 SO	WEST VALLEY CITY	UT	84128	04/01/2016	01/10/2022
CH0818490	SMITHS FOOD & DRUG CTRS	SMITH'S DRUG KING PHARMACY #75	632 SOUTH 100 WEST	PAYSON	UT	84651	01/01/2014	01/10/2022
CH0818490	SMITHS FOOD & DRUG CTRS	SMITH'S PHARMACY #178	156 SOUTH MAIN	BRIGHAM CITY	UT	84302	01/01/2014	01/10/2022
CH0818490	SMITHS FOOD & DRUG CTRS	DBA SMITH'S FOOD & DRUG #133	845 EAST 4500 SOUTH	SALT LAKE CITY	UT	84107	01/01/2014	01/10/2022
CH0818490	SMITHS FOOD & DRUG CTRS	SMITH'S FOOD DRUG #149	1170 EAST GENTILE	LAYTON	UT	84040	01/01/2014	01/10/2022
CH0818490	SMITHS FOOD & DRUG CTRS	DBA SMITH'S FOOD & DRUG #135	1316 NORTH HIGHWAY 89	FARMINGTON	UT	84025	01/01/2014	01/06/2016
CH0818490	THE KROGER CO., KS 113	1220 S. LIPAN STREET		DENVER	CO	80223	04/01/2020	08/15/2021
CH0818490	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2020
CH081849C	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2023
CH081849D	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2023
CH081849E	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2023
CH081849F	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2025
CH0818490	WAL-MART PHARMACY 10-1438	1330 SOUTH PROVIDENCE CTR DR.		CEDAR CITY	UT	84720	01/01/2025
CH081849F	WAL-MART PHARMACY 10-1438	1330 SOUTH PROVIDENCE CTR DR.		CEDAR CITY	UT	84720	01/01/2025
CH081849C	WAL-MART PHARMACY 10-1438	1330 SOUTH PROVIDENCE CTR DR.		CEDAR CITY	UT	84720	01/01/2025
CH081849D	WAL-MART PHARMACY 10-1438	1330 SOUTH PROVIDENCE CTR DR.		CEDAR CITY	UT	84720	01/01/2025
CH081849E	WAL-MART PHARMACY 10-1438	1330 SOUTH PROVIDENCE CTR DR.		CEDAR CITY	UT	84720	01/01/2025
CH0818490	WAL-MART PHARMACY 10-1439	625 W. TELEGRAPH STREET		WASHINGTON	UT	84780	07/01/2020
CH081849C	WAL-MART PHARMACY 10-1439	625 W. TELEGRAPH STREET		WASHINGTON	UT	84780	04/01/2023
CH081849E	WAL-MART PHARMACY 10-1439	625 W. TELEGRAPH STREET		WASHINGTON	UT	84780	04/01/2023
CH081849D	WAL-MART PHARMACY 10-1439	625 W. TELEGRAPH STREET		WASHINGTON	UT	84780	04/01/2023
CH081849F	WAL-MART PHARMACY 10-1439	625 W. TELEGRAPH STREET		WASHINGTON	UT	84780	01/01/2025
CH0818490	WAL-MART PHARMACY 10-3220	2610 SOUTH PIONEER ROAD		ST GEORGE	UT	84790	07/01/2020
CH081849C	WAL-MART PHARMACY 10-3220	2610 SOUTH PIONEER ROAD		ST GEORGE	UT	84790	04/01/2023
CH081849E	WAL-MART PHARMACY 10-3220	2610 SOUTH PIONEER ROAD		ST GEORGE	UT	84790	04/01/2023
CH081849D	WAL-MART PHARMACY 10-3220	2610 SOUTH PIONEER ROAD		ST GEORGE	UT	84790	04/01/2023
CH081849F	WAL-MART PHARMACY 10-3220	2610 SOUTH PIONEER ROAD		ST GEORGE	UT	84790	01/01/2025
CH0818490	WAL-MART PHARMACY 10-4678	180 NORTH 3400 WEST		HURRICANE	UT	84737	07/01/2020
CH081849C	WAL-MART PHARMACY 10-4678	180 NORTH 3400 WEST		HURRICANE	UT	84737	04/01/2023
CH081849D	WAL-MART PHARMACY 10-4678	180 NORTH 3400 WEST		HURRICANE	UT	84737	04/01/2023
CH081849E	WAL-MART PHARMACY 10-4678	180 NORTH 3400 WEST		HURRICANE	UT	84737	04/01/2023
CH081849F	WAL-MART PHARMACY 10-4678	180 NORTH 3400 WEST		HURRICANE	UT	84737	01/01/2025
CH0818490	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2020
CH081849C	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2023
CH081849E	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2023
CH081849D	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2023
CH081849F	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2025
CH081849E	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH081849C	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH0818490	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH081849D	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH081849F	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/01/2025
CH081849D	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH0818490	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH081849C	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH081849E	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH081849F	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		2/10/2025 1:26:39 PM	2/10/2025 1:26 PM
Addresses	Billing Address	Insert	Change Request		Southwest Utah Community Health Center DBA Family Healthcare 2276 E Riverside Dr. St. George, UT 84790	7/11/2024 9:12 AM
Details	State	Update		Approved	Active	4/1/2024 12:01 AM
Details	Entity Subname	Update	Change Request	Family Healthcare Springdale Clinic	Family Healthcare Zion Canyon Clinic	3/18/2024 4:48 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1477333417	3/13/2024 7:01 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		UT	3/13/2024 7:01 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1346986908	3/13/2024 7:01 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		UT	3/13/2024 7:01 PM
Contacts	Signed By	Insert	New Registration		Wright, Lori CEO Southwest Utah Community Health Center 4358795101	3/11/2024 7:30 AM
Details	340B ID	Update	New Registration		CH081849F	3/11/2024 7:30 AM
Dates	Participating Approval Date	Update	New Registration		3/11/2024 7:30:54 AM	3/11/2024 7:30 AM
Details	State	Update	New Registration	Pending	Approved	3/11/2024 7:30 AM
Dates	Signed By Date	Update	New Registration		1/12/2024 7:33:09 PM	3/11/2024 7:30 AM
Dates	Start Date	Update	New Registration		4/1/2024 12:00:00 AM	3/11/2024 7:30 AM
Addresses	Main Address	Insert	New Registration		120 Lion Blvd Springdale, UT 84767-7724	1/12/2024 7:33 PM
Contacts	Authorizing Official	Insert	New Registration		Wright, Lori CEO Southwest Utah Community Health Center 4358795101	1/12/2024 7:33 PM
Contacts	Primary Contact	Insert	New Registration		Jones, Kevin Pharmacist Southwest Utah Community Health Center, Inc. 4358795101	1/12/2024 7:33 PM
Details	Assistance Received From Date	Insert	New Registration			1/12/2024 7:33 PM
Details	Assistance Received To Date	Insert	New Registration			1/12/2024 7:33 PM
Details	Last Recertification Date	Insert	New Registration			1/12/2024 7:33 PM
Details	Grant Number	Insert	New Registration		H80CS07890	1/12/2024 7:33 PM
Details	340B ID	Insert	New Registration			1/12/2024 7:33 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/12/2024 7:33 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/12/2024 7:33 PM
Details	Medicare Provider Number	Insert	New Registration			1/12/2024 7:33 PM
Details	Entity Name	Insert	New Registration		Southwest Utah Community Health Center, Inc.	1/12/2024 7:33 PM
Details	NOFO Number	Insert	New Registration			1/12/2024 7:33 PM
Details	Program Code	Insert	New Registration		CH	1/12/2024 7:33 PM
Details	Entity Subname	Insert	New Registration		Family Healthcare Springdale Clinic	1/12/2024 7:33 PM
Dates	Participating Approval Date	Insert	New Registration			1/12/2024 7:33 PM
Details	State	Insert	New Registration		Pending	1/12/2024 7:33 PM
Dates	Registration Date	Insert	New Registration		1/12/2024 7:33:04 PM	1/12/2024 7:33 PM
Dates	Signed By Date	Insert	New Registration			1/12/2024 7:33 PM
Dates	Start Date	Insert	New Registration			1/12/2024 7:33 PM
Terminations	Termination Comments	Insert	New Registration			1/12/2024 7:33 PM
Terminations	Termination Date	Insert	New Registration			1/12/2024 7:33 PM
Terminations	Termination Effective Date	Insert	New Registration			1/12/2024 7:33 PM
Terminations	Termination Reason	Insert	New Registration			1/12/2024 7:33 PM

340B Drug Pricing Program Database