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AZINA, LLC
CAH151332-00 DECATUR COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
DECATUR COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151332-00
Entity Address
720 NORTH LINCOLN STREET
GREENSBURG, IN 47240
Medicare Provider Number
151332
Participating Start Date
8/18/2010
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
AZINA, LLC
Pharmacy Address
5515 PARKCENTER CIR
SUITE 175
DUBLIN, OH 43017
Pharmacy Comments
Contract Details
Approval Date
7/13/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rex McKinney, CEO
(812) 663-1171
Contract Pharmacy Representative
Comprehensive Pharmacy Services
Doug Massey, EVP, Specialty and Ambulatory Operations
(800) 968-6962
Signed By Date
7/13/2023
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