Contract Pharmacy Details

M.N. PHARMACY LLC
CH050990 HEALTHSOURCE OF OHIO, INC.

Covered Entity Details

Entity Name

HEALTHSOURCE OF OHIO, INC.

Subdivision Name

HEALTHSOURCE OF OHIO, INC.

Type

HRSA-Funded Health Center

340B ID

CH050990

Entity Address

424 WARDS CORNER STE 200
LOVELAND, OH 45140-6966

Grant Number

H80CS00201

Participating Start Date

10/1/1998

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

M.N. PHARMACY LLC

Pharmacy Address

DBA AMAZON PHARMACY #003
6701 NW 7TH ST., STE. #199
MIAMI, FL 33126

Pharmacy Comments

Contract Details

Approval Date

7/2/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/31/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

KIM PATTON, CEO
(513) 576-7700

Contract Pharmacy Representative

PILLPACK, INC.
GEOFF SWINDLE, CHIEF BUSINESS OFFICER
(855) 745-5725

Signed By Date

7/2/2019

340B Drug Pricing Program Database