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BANDY'S PHARMACY II
CAH141308-00 Washington County Hospital
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Covered Entity Details
Entity Name
Washington County Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141308-00
Entity Address
705 South Grand Avenue
Nashville, IL 62263
Medicare Provider Number
141308
Participating Start Date
1/1/2013
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
BANDY'S PHARMACY II
Pharmacy Address
BANDY'S APOTHECARY SHOPS INC.
817 E MCCORD ST
CENTRALIA, IL 62801-3044
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/7/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brian K Monsma, President
(618) 327-8326
Contract Pharmacy Representative
Bandy's
Eric Bandy, CFO
(618) 548-4000
Signed By Date
1/14/2022
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