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ASCENSION PHARMACY SERVICES, LLC
CAH451365-00 Ascension Seton d/b/a Ascension Seton Highland Lakes
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Covered Entity Details
Entity Name
Ascension Seton d/b/a Ascension Seton Highland Lakes
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH451365-00
Entity Address
3201 S WATER STREET
BURNET, TX 78611-4510
Medicare Provider Number
451365
Participating Start Date
8/25/2010
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
ASCENSION PHARMACY SERVICES, LLC
Pharmacy Address
DBA ASCENSION RX 1303
30055 NORTHWESTERN HWY STE 225
FARMINGTON HILLS, MI 48334
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
1/26/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Litterer, VP-COO SHL
(512) 715-3008
Contract Pharmacy Representative
Ascension Pharmacy Services, LLC
Lynn Eschenbacher, Chief Pharmacy Officer
(314) 884-0593
Signed By Date
1/14/2022
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