340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HY-VEE PHARMACY
SCH140001-00 GRAHAM HOSPITAL ASSOCIATION
Print
Covered Entity Details
Entity Name
GRAHAM HOSPITAL ASSOCIATION
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH140001-00
Entity Address
210 W. Walnut Street
Canton, IL 61520
Medicare Provider Number
140001
Participating Start Date
7/1/2015
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
HY-VEE PHARMACY
Pharmacy Address
2030 EAST MAIN ST
GALESBURG, IL 61401
Pharmacy Comments
Contract Details
Approval Date
10/17/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/4/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Holly Henline, VP of Ancillary Services & Corporate Compliance Officer
(309) 647-5240 Ext: 2709
Contract Pharmacy Representative
Hy-Vee, Inc
Ashley Plum, 340B Coordinator
(515) 559-5708
Signed By Date
10/17/2022
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