340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DISCOUNT DRUG MART #63
CAH361323-00 Aultman Orrville Hospital
Print
Covered Entity Details
Entity Name
Aultman Orrville Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH361323-00
Entity Address
832 SOUTH MAIN STREET
ORRVILLE, OH 44667
Medicare Provider Number
361323
Participating Start Date
1/1/2011
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
DISCOUNT DRUG MART #63
Pharmacy Address
592 12TH STREET NW
CARROLLTON, OH 44615
Pharmacy Comments
Contract Details
Approval Date
4/5/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Dale Basso, Associate CFO
(330) 684-4763
Contract Pharmacy Representative
Discount Drug Mart
Joseph V Muha, Corporate Counsel/Director of Pharmacy Compliance
(330) 725-2340 Ext: 84480
Signed By Date
4/5/2021
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