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COMMONSPIRIT KANSAS, INC.
SCH170023-00 St. Catherine Hospital - Garden City
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Covered Entity Details
Entity Name
St. Catherine Hospital - Garden City
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH170023-00
Entity Address
401 E Spruce St
GARDEN CITY, KS 67846
Medicare Provider Number
170023
Participating Start Date
9/15/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
COMMONSPIRIT KANSAS, INC.
Pharmacy Address
ST. CATHERINE HOSPITAL - GARDEN CITY
401 E SPRUCE ST
GARDEN CITY, KS 67846
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Ownership change
Contacts
Covered Entity Signing Official
AMANDA VAUGHAN, CFO
(620) 272-2554
Contract Pharmacy Representative
Centura Health
VINNY POLITO, SYSTEM DIRECTOR AMB PHARMACY
(303) 673-1014
Signed By Date
4/15/2019
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