340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
THE CORNER DRUG STORE
SCH260195-00 CITIZENS MEMORIAL HOSPITAL DISTRICT
Print
Covered Entity Details
Entity Name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH260195-00
Entity Address
1500 NORTH OAKLAND
BOLIVAR, MO 65613
Medicare Provider Number
260195
Participating Start Date
11/1/2021
Last Recertification Date
Entity Termination Date
4/1/2022
Pharmacy Details
Pharmacy Name
THE CORNER DRUG STORE
Pharmacy Address
BUFFALO PROFESSIONAL PHARM INC
308 W DALLAS ST
BUFFALO, MO 65622-7635
Pharmacy Comments
Contract Details
Approval Date
11/1/2021
Contract Begin Date
11/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Renee Marie Meyer, Chief Financial Officer
(417) 328-6258
Contract Pharmacy Representative
Hermitage Professional Pharmacy
Alvin L. Nyberg, Pharmacist-In-Charge
(417) 345-2321
Signed By Date
10/4/2021
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