340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BANDY'S LTC LLC
RRC140034-00 ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
Print
Covered Entity Details
Entity Name
ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140034-00
Entity Address
400 NORTH PLEASANT AVENUE
CENTRALIA, IL 62801
Medicare Provider Number
140034
Participating Start Date
4/1/2011
Last Recertification Date
9/19/2022
Entity Termination Date
7/1/2023
Pharmacy Details
Pharmacy Name
BANDY'S LTC LLC
Pharmacy Address
DBA BANDY'S LONG TERM CARE PHARMACY
1415 W WHITTAKER ST
SALEM, IL 62881-2015
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Damon Harbison, President
(618) 436-8000
Contract Pharmacy Representative
Bandy's
Eric Bandy, CFO
(618) 548-4000
Signed By Date
10/15/2021
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