340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MERCY EAST PHARMACY
DSH520066 MERCY HEALTH SYSTEM CORPORATION
Print
Covered Entity Details
Entity Name
MERCY HEALTH SYSTEM CORPORATION
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH520066
Entity Address
1000 MINERAL POINT AVE
JANESVILLE, WI 53547-5003
Medicare Provider Number
520066
Participating Start Date
4/1/2019
Last Recertification Date
8/30/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
MERCY EAST PHARMACY
Pharmacy Address
3524 E MILWAUKEE ST
JANESVILLE, WI 53546-1626
Pharmacy Comments
Contract Details
Approval Date
4/9/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/6/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Cook, Senior VP / CFO
(608) 756-6642
Contract Pharmacy Representative
Mercy Health System
Amy Reilly, MALL PHARMACY MANGER
(608) 755-8747
Signed By Date
4/9/2019
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