340B Drug Pricing Program Database

Pharmacy Name

NORTHSIDE MVHC PHARMACY

Pharmacy Address

716 ADAIR AVE
ZANESVILLE, OH 43701-2836

Pharmacy Comments

Approval Date

10/23/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/31/2023
Pharmacy closed

Covered Entity Signing Official

Rebecca F Carr, Chief Financial Officer
(740) 891-9094

Contract Pharmacy Representative

Northside Pharmacy
EJ Stoepfel, Director
(740) 454-5666

Signed By Date

10/8/2019