340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PREMIER HEALTH PHARMACY-FIDELITY
DSH360076 ATRIUM MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ATRIUM MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360076
Entity Address
ONE MEDICAL CENTER DRIVE
MIDDLETOWN, OH 45005-1006
Medicare Provider Number
360076
Participating Start Date
10/1/2020
Last Recertification Date
8/23/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
PREMIER HEALTH PHARMACY-FIDELITY
Pharmacy Address
3170 KETTERING BLVD BLDG B
MORAINE, OH 45439
Pharmacy Comments
Contract Details
Approval Date
4/18/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Craig Allen Ganger, Chief Financial Officer
(937) 499-9988
Contract Pharmacy Representative
Premier Health
Eric Napier, Director of Outpatient Pharmacy
(937) 208-6534
Signed By Date
4/18/2021
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