340B Drug Pricing Program Database


SAM'S HEALTH MART PHARMACY #3 - information as of 4/27/2025 1:53:34 AM


SAM'S HEALTH MART PHARMACY #3

SAM'S PRESCRIPTION SHOP INC
300 N. CHURCH ST.
PO BOX 509
FAYETTE, MO 65248-0509



  • Contracts
  • History
Contracts
Contract Detail340B IDEntity NameSub NameEntity TypeAddressAddress Cont.CityStateBegin DateTerm DateEdit Date
DetailsDSH260141University of Missouri Health Care Disproportionate Share HospitalOne Hospital Drive
ColumbiaMO10/01/2019 10/1/2019 12:05 AM
DetailsDSH260142JOHN FITZGIBBON MEMORIAL HOSPITAL Disproportionate Share Hospital2305 SOUTH HIGHWAY 65
MARSHALLMO04/01/2023 4/1/2023 12:01 AM
DetailsDSH260142AJOHN FITZGIBBON MEMORIAL HOSPITALAkeman-McBurney Medical ClinicDisproportionate Share Hospital420 W. Front St.
SlaterMO04/01/2023 4/1/2023 12:01 AM
DetailsDSH260142BJOHN FITZGIBBON MEMORIAL HOSPITALGrand River Medical ClinicDisproportionate Share Hospital815 E. Broadway
BrunswickMO04/01/2023 4/1/2023 12:01 AM
DetailsDSH260142CJOHN FITZGIBBON MEMORIAL HOSPITALJOHN FITZGIBBON MEM HOSPITAL INC - Fitzgibbon Family HealthDisproportionate Share Hospital600 W MORRISON ST STE 5
FAYETTEMO04/01/2023 4/1/2023 12:01 AM
DetailsDSH260142DJOHN FITZGIBBON MEMORIAL HOSPITALJOHN FITZGIBBON HOSPITAL INC - Pilot Grove Medical ClinicDisproportionate Share Hospital212 COLLEGE ST PILOT GROVE MEDICAL CLINIC AT FITZG
PILOT GROVEMO01/01/2024 1/1/2024 12:01 AM
DetailsDSH260142EJOHN FITZGIBBON MEMORIAL HOSPITALJOHN FITZGIBBON MEMORIAL HOSP INC - Mid-Missouri Family HealthDisproportionate Share Hospital2303 S HIGHWAY 65 STE A MID MISSOURI FAMILY HEALTH AT FITZG
MARSHALLMO01/01/2024 1/1/2024 12:01 AM
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesPharmacy AddressInsert  SAM'S HEALTH MART PHARMACY #3 SAM'S PRESCRIPTION SHOP INC 300 N. CHURCH ST. PO BOX 509 FAYETTE, MO 65248-05092/5/2021 10:46 AM
AddressesPharmacy AddressUpdate SAM'S HEALTH MART PHARMACY #3 SAM'S PRESCRIPTION SHOP INC 300 N. CHURCH FAYETTE, MO 65248-0509SAM'S HEALTH MART PHARMACY #3 SAM'S PRESCRIPTION SHOP INC 300 N. CHURCH P O BOX 509 FAYETTE, MO 65248-05093/28/2013 4:22 PM
DetailsCommentsInsert   3/28/2013 4:22 PM
DetailsIs DeletedInsert  False3/28/2013 4:22 PM
AddressesPharmacy AddressInsert  SAM'S HEALTH MART PHARMACY #3 SAM'S PRESCRIPTION SHOP INC 300 N. CHURCH FAYETTE, MO 65248-05093/28/2013 4:22 PM
DetailsNameInsert  SAM'S HEALTH MART PHARMACY #33/28/2013 4:22 PM