340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MARSHFIELD CLINIC PHARMACY
CAH521323-03 Memorial Medical Center
Print
Covered Entity Details
Entity Name
Memorial Medical Center
Subdivision Name
MCHS-Colby - Colby-Abbotsford Clinic
Type
Critical Access Hospital
340B ID
CAH521323-03
Entity Address
111 E. Dehne Drive
Colby, WI 54421
Medicare Provider Number
521323
Outpatient Facility Provider Number
Participating Start Date
4/1/2022
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
MARSHFIELD CLINIC PHARMACY
Pharmacy Address
MARSHFIELD CLINIC SPECIALTY PHARMACY
1000 N OAK AVE
MARSHFIELD, WI 54449
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sally Zillman, Chief Administrative Officer, MMC - Neillsville
(715) 819-8227
Contract Pharmacy Representative
MMC
Holly Fayas, Manager-Pharmacy Services
(715) 387-9100
Signed By Date
4/13/2022
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