340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AXLINE'S INC
SCH140089-00 MCDONOUGH DISTRICT HOSPITAL
Print
Covered Entity Details
Entity Name
MCDONOUGH DISTRICT HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH140089-00
Entity Address
525 E. GRANT
MACOMB, IL 61455
Medicare Provider Number
140089
Participating Start Date
7/1/2017
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
AXLINE'S INC
Pharmacy Address
DBA AXLINE PHARMACY 08
401 W MAIN ST
BUSHNELL, IL 61422-1353
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/20/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William R Murdock, President & CEO
(309) 833-4101 Ext: 13499
Contract Pharmacy Representative
Axline Pharmacy
Troy L. Williams, Owner
(309) 828-6979
Signed By Date
7/15/2019
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