340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HealthSource Mt. Orab Pharmacy
CH05099V HEALTHSOURCE OF OHIO, INC.
Print
Covered Entity Details
Entity Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HealthSource Seaman
Type
HRSA-Funded Health Center
340B ID
CH05099V
Entity Address
218 STERN DRIVE
SEAMAN, OH 45679
Grant Number
H80CS00201
Participating Start Date
10/1/2000
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HealthSource Mt. Orab Pharmacy
Pharmacy Address
150 Health Partners Circle
Mt. Orab, OH 45154
Pharmacy Comments
Contract Details
Approval Date
11/10/2010
Contract Begin Date
12/1/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/11/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
11/1/2010
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