340B Drug Pricing Program Database

Pharmacy Name

ASCENSION RX (STORE #1208)

Pharmacy Address

SAINT AGNES COMMUNITY HOSP-PHARMACY
900 S CATON AVE FL 1
BALTIMORE, MD 21229

Pharmacy Comments

Approval Date

4/15/2020

Contract Begin Date

4/28/2020

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Mitchell Gardner Lomax, CFO
(667) 234-2926

Contract Pharmacy Representative

Saint Agnes Hospital
Odunayo Obisesan, Director of Pharmacy
(667) 234-2055

Signed By Date

4/15/2020