340B Drug Pricing Program Database

Pharmacy Name

CITIZEN'S MEMORIAL HOSPITAL

Pharmacy Address

CITIZENS MEMORIAL HOSPITAL DISTRICT OF P
CITIZEN'S MEM. HOSP. PHARM.
1301B N OAKLAND
BOLIVAR, MO 65613

Pharmacy Comments

Approval Date

4/13/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/5/2018
Ownership change

Covered Entity Signing Official

Donald J. Babb, Chief Executive Officer
(417) 328-6501

Contract Pharmacy Representative

Citizens Memorial Health Care Foundation
Donald Babb, Chief Executive Officer
(417) 328-6501

Signed By Date

4/13/2017