340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ALTON DRUG STORE
DSH260078 Ozarks Medical Center DBA Ozarks Healthcare
Print
Covered Entity Details
Entity Name
Ozarks Medical Center DBA Ozarks Healthcare
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260078
Entity Address
1100 KENTUCKY AVENUE
WEST PLAINS, MO 65775-1100
Medicare Provider Number
260078
Participating Start Date
1/1/2005
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
ALTON DRUG STORE
Pharmacy Address
C AND P ALTON VENTURES LLC
201 STATE HIGHWAY 19
ALTON, MO 65606
Pharmacy Comments
Contract Details
Approval Date
10/10/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timothy J Pollard, CFO
(417) 256-9111 Ext: 6031
Contract Pharmacy Representative
Alton Drug Store
Matt Combs, Owner
(417) 778-7000
Signed By Date
10/10/2019
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