340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MEDICAP PHARMACY
DSH260113 MISSOURI DELTA MEDICAL CENTER
Print
Covered Entity Details
Entity Name
MISSOURI DELTA MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260113
Entity Address
1008 NORTH MAIN
SIKESTON, MO 63801
Medicare Provider Number
260113
Participating Start Date
7/1/2006
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
MEDICAP PHARMACY
Pharmacy Address
SCRIPT MASTERS, INC.
507 NORTH MAIN
SIKESTON, MO 63801-2105
Pharmacy Comments
05/31/2012 changed address (removed street from line 1)
Contract Details
Approval Date
3/23/2012
Contract Begin Date
3/23/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/14/2015
Ownership change
Contacts
Covered Entity Signing Official
JASON SCHRUMPF, CEO
(573) 472-7600
Contract Pharmacy Representative
Ronnie Hamra, Pharmacist/Owner
(573) 471-4401
Signed By Date
3/21/2012
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