340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVELLA OF SACRAMENTO, INC.
DSH020012 FAIRBANKS MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
FAIRBANKS MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH020012
Entity Address
1650 COWLES STREET
FAIRBANKS, AK 99701-5998
Medicare Provider Number
020012
Participating Start Date
9/9/2005
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
AVELLA OF SACRAMENTO, INC.
Pharmacy Address
2288 AUBURN BLVD #102
SACRAMENTO, CA 95821
Pharmacy Comments
01/28/2013 name update (was GREATER SACRAMENTO PHARMACY, INC.)
Contract Details
Approval Date
7/30/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jim Lynch, CFO
(907) 458-5300
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
7/30/2015
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