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FAMILY DRUG
DSH150065 SCHNECK MEDICAL CENTER
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Covered Entity Details
Entity Name
SCHNECK MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH150065
Entity Address
411 WEST TIPTON STREET
SEYMOUR, IN 47274
Medicare Provider Number
150065
Participating Start Date
10/1/2016
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
FAMILY DRUG
Pharmacy Address
DBA FAMILY DRUG
810 W COMMERCE ST
BROWNSTOWN, IN 47220-1200
Pharmacy Comments
Contract Details
Approval Date
10/13/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Deborah Ridlen, VP Finance/CFO
(812) 522-0170
Contract Pharmacy Representative
Family Drug
Julie Branaman, PharmD
(812) 358-4502
Signed By Date
10/13/2018
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