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THE MEDICINE SHOPPE
CHC00680-00 COMMUNITY HEALTH & EMERGENCY SERVICES, INC
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Covered Entity Details
Entity Name
COMMUNITY HEALTH & EMERGENCY SERVICES, INC
Subdivision Name
CAIRO MEGA CLINIC
Type
HRSA-Funded Health Center
340B ID
CHC00680-00
Entity Address
13245 Kessler Rd
Cairo, IL 62914-3101
Grant Number
H80CS00680
Participating Start Date
1/1/2009
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THE MEDICINE SHOPPE
Pharmacy Address
1315 W MAIN ST
MARION, IL 62959
Pharmacy Comments
Contract Details
Approval Date
10/5/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Frederick Bernstein, CEO
(618) 457-0450 Ext: 3901
Contract Pharmacy Representative
Medicine Shoppe
Brad Ledbetter, Vice President
(618) 252-5349
Signed By Date
10/5/2020
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