340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
THOMPSON DEAN DRUG
RRC160153-00 MercyOne Siouxland Medical Center
Print
Covered Entity Details
Entity Name
MercyOne Siouxland Medical Center
Subdivision Name
Type
Rural Referral Center
340B ID
RRC160153-00
Entity Address
801 FIFTH STREET
SIOUX CITY, IA 51101
Medicare Provider Number
160153
Participating Start Date
10/1/2018
Last Recertification Date
9/4/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
THOMPSON DEAN DRUG
Pharmacy Address
911 W 7TH ST
SIOUX CITY, IA 51103
Pharmacy Comments
Contract Details
Approval Date
10/2/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/16/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Beth Hughes, President
(712) 279-2018
Contract Pharmacy Representative
Thompson Dean Drug
GARY MALY, PRESIDENT
(712) 252-2761
Signed By Date
10/2/2020
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