340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MISSOURI CVS PHARMACY, L.L.C.
DSH260091 SSM HEALTH ST MARY'S HOSPITAL-STL
Print
Covered Entity Details
Entity Name
SSM HEALTH ST MARY'S HOSPITAL-STL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260091
Entity Address
6420 CLAYTON ROAD
ST. LOUIS, MO 63117
Medicare Provider Number
260091
Participating Start Date
10/1/2006
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 4403
7470 MANCHESTER RD.
MAPLEWOOD, MO 63143
Pharmacy Comments
Contract Details
Approval Date
7/5/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/13/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Karen D. Rewerts, Regional VP of Financa/CFO
(314) 989-2034
Contract Pharmacy Representative
CVS Health
Jaclyn Parfitt, 340B Operations Manager
(401) 770-6467
Signed By Date
7/5/2016
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