Contract Pharmacy Details

FISHER PHARMACY
CH05332D Southern Illinois Health Care Foundation, Inc.

Covered Entity Details

Entity Name

Southern Illinois Health Care Foundation, Inc.

Subdivision Name

ADULT CARE CENTER

Type

HRSA-Funded Health Center

340B ID

CH05332D

Entity Address

6010 Bond Ave
Centreville, IL 62207-2328

Grant Number

H80CS00195

Participating Start Date

7/1/2001

Last Recertification Date

2/13/2017

Entity Termination Date

4/1/2017

Pharmacy Details

Pharmacy Name

FISHER PHARMACY

Pharmacy Address

B & D CORPORATION
2007 CAMP JACKSON ROAD
CAHOKIA, IL 62206

Pharmacy Comments

Contract Details

Approval Date

11/1/2004

Contract Begin Date

11/1/2004

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2017

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

340B Drug Pricing Program Database