Contract Pharmacy Details

MEDICINE EXPRESS
HV05332P SIHF Healthcare

Covered Entity Details

Entity Name

SIHF Healthcare

Subdivision Name

SIHF Healthcare - Vandalia

Type

Ryan White Part C

340B ID

HV05332P

Entity Address

1510 Sunset Dr
Vandalia, IL 62471

Grant Number

H76HA00579

Participating Start Date

7/1/2005

Last Recertification Date

2/22/2025

Pharmacy Details

Pharmacy Name

MEDICINE EXPRESS

Pharmacy Address

1704 NORTH ILLINOIS
SUITE 200
SWANSEA, IL 62226

Pharmacy Comments

Contract Details

Approval Date

7/1/2005

Contract Begin Date

7/1/2005

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/22/2019
Pharmacy closed

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

6/9/2005

340B Drug Pricing Program Database