340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CORAM ALTERNATE SITE SERVICES, INC.
DSH150169 COMMUNITY HOSPITAL OF INDIANA INC.
Print
Covered Entity Details
Entity Name
COMMUNITY HOSPITAL OF INDIANA INC.
Subdivision Name
Community Hospital North
Type
Disproportionate Share Hospital
340B ID
DSH150169
Entity Address
7150 CLEARVISTA DRIVE
INDIANAPOLIS, IN 46256
Medicare Provider Number
150169
Participating Start Date
4/1/2016
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
CORAM ALTERNATE SITE SERVICES, INC.
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
431 FERNHILL AVENUE
FORT WAYNE, IN 46805
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
1/30/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kathleen R. Krusie, SVP President North Region
(317) 621-6095
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
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