340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
STAKER'S SERVICE DRUGS INC
FQHCLA396 SHAWNEE MENTAL HEALTH CENTER INC
Print
Covered Entity Details
Entity Name
SHAWNEE MENTAL HEALTH CENTER INC
Subdivision Name
Portsmouth Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA396
Entity Address
901 Washington St
Portsmouth, OH 45662-3944
Grant Number
LALCS32583
Participating Start Date
10/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
STAKER'S SERVICE DRUGS INC
Pharmacy Address
826 CHILLICOTHE ST
PORTSMOUTH, OH 45662-4028
Pharmacy Comments
Contract Details
Approval Date
7/7/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/19/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Cynthia Holstein, CEO
(740) 442-7670
Contract Pharmacy Representative
Staker's Service Drugs, Inc.
Chris A Staker, President
(740) 353-1135
Signed By Date
7/7/2022
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