340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SULLIVAN DRUGS INC
CHC22690-01 MACOUPIN, COUNTY OF
Print
Covered Entity Details
Entity Name
MACOUPIN, COUNTY OF
Subdivision Name
Macoupin County Public Health Clinic Site
Type
HRSA-Funded Health Center
340B ID
CHC22690-01
Entity Address
1115 E. Morgan Street
Carlinville, IL 62626-1430
Grant Number
H80CS22690
Participating Start Date
1/1/2020
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
SULLIVAN DRUGS INC
Pharmacy Address
105 W MAIN ST
MOUNT OLIVE, IL 62069-1609
Pharmacy Comments
Contract Details
Approval Date
10/11/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kent Tarro, CEO
(217) 825-6705
Contract Pharmacy Representative
Sullivans Drugs
Maurice Sullivan, CEO
(217) 839-2909
Signed By Date
10/11/2019
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