Contract Pharmacy Details

AZINA, LLC
CAH361309-00 HENRY COUNTY HOSPITAL

Covered Entity Details

Entity Name

HENRY COUNTY HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH361309-00

Entity Address

1600 E. RIVERVIEW
NAPOLEON, OH 43545

Medicare Provider Number

361309

Participating Start Date

7/1/2011

Last Recertification Date

8/13/2024

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

Contacts

Covered Entity Signing Official

Kristi Barnd, Chief Executive Officer
(419) 591-3838

Contract Pharmacy Representative

Comprehensive Pharmacy Services
Doug Massey, EVP, Specialty and Ambulatory Operations
(800) 968-6962

Signed By Date

7/13/2023

340B Drug Pricing Program Database