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APOTHECARY OF MEDICAL ASSOCIATES
SCH450370-00 COLUMBUS COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
COLUMBUS COMMUNITY HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH450370-00
Entity Address
110 SHULT DRIVE
COLUMBUS, TX 78934
Medicare Provider Number
450370
Participating Start Date
1/1/2015
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
APOTHECARY OF MEDICAL ASSOCIATES
Pharmacy Address
38 EAST AVE
SCHULENBURG, TX 78956-1611
Pharmacy Comments
Contract Details
Approval Date
1/7/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Vanek, CEO
(979) 493-7561
Contract Pharmacy Representative
Apothecary of Medical Associates
Nidhin Joseph, Owner
(979) 493-3265
Signed By Date
1/7/2020
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