340B Drug Pricing Program Database

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SHOPKO PHARMACY #2142
DSH160057AG Southeast Iowa Regional Medical Center

Covered Entity Details

OCCUPATIONAL HEALTH - SOUTHEAST IOWA REGIONAL MEDICAL CENTER - Occupational Health
Disproportionate Share Hospital
DSH160057AG
1401 West Agency Road
West Burlington, IA 52655
160057
4/1/2022
8/12/2024


Pharmacy Details

SHOPKO PHARMACY
4810 AVENUE O
FORT MADISON, IA 52627

Contract Details

2/18/2022
4/1/2022

4/1/2022
Pharmacy closed


Contacts


Jeremy Alexander, CFO
(319) 768-3280



Southeast Iowa Regional Medical Center
Steve Frigo, Director, Pharmacy
(319) 768-3971
2/18/2022