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AZINA, LLC
CAH141324-00 Ferrell Hospital Community Foundation dba Ferrell Hospital
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Covered Entity Details
Entity Name
Ferrell Hospital Community Foundation dba Ferrell Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141324-00
Entity Address
1201 Pine Street
Eldorado, IL 62930
Medicare Provider Number
141324
Participating Start Date
4/1/2012
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
AZINA, LLC
Pharmacy Address
5515 PARKCENTER CIR
SUITE 175
DUBLIN, OH 43017
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Angela Marie Craig, Controller
(618) 273-3361 Ext: 157
Contract Pharmacy Representative
Comprehensive Pharmacy Services
Doug Massey, EVP, Specialty and Ambulatory Operations
(800) 968-6962
Signed By Date
4/17/2023
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