340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HY-VEE PHARMACY 1065
CAH161358-00 Wayne County Hospital
Print
Covered Entity Details
Entity Name
Wayne County Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161358-00
Entity Address
417 S East Street
Corydon, IA 50060
Medicare Provider Number
161358
Participating Start Date
4/1/2013
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
HY-VEE PHARMACY 1065
Pharmacy Address
2001 WEST COURT
CHARITON, IA 50049
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/4/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Denise Hook, CFO
(641) 872-5277
Contract Pharmacy Representative
Hy-vee Inc.
Marshall Sanders, 340B Program Manager
(515) 267-6009
Signed By Date
10/15/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session