340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SCOTT PHARMACY
CAH161312-02 GUTTENBERG MUNICIPAL HOSPITAL
Print
Covered Entity Details
Entity Name
GUTTENBERG MUNICIPAL HOSPITAL
Subdivision Name
Cornerstone Family Practice
Type
Critical Access Hospital
340B ID
CAH161312-02
Entity Address
101 East Watson
Garnavillo, IA 52049
Medicare Provider Number
161312
Outpatient Facility Provider Number
168550
Participating Start Date
1/1/2019
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
SCOTT PHARMACY
Pharmacy Address
238 S MAIN ST
PO BOX 188
FAYETTE, IA 52142
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/12/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lisa Manson, Director of Ambulatory Services
(563) 252-1121
Contract Pharmacy Representative
Scott Pharmacy
David J Scott, PharmD, MBA
(563) 425-4530
Signed By Date
1/15/2019
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