340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MISSOURI CVS PHARMACY, L.L.C.
DSH260040 LESTER E COX MEDICAL CENTERS
Print
Covered Entity Details
Entity Name
LESTER E COX MEDICAL CENTERS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260040
Entity Address
3801 SOUTH NATIONAL AVE
SPRINGFIELD, MO 65807
Medicare Provider Number
260040
Participating Start Date
1/1/2007
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 3897
3030 SOUTH CAMPBELL AVE
SPRINGFIELD, MO 65807
Pharmacy Comments
Contract Details
Approval Date
10/15/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jake McWay, SVP - CFO
(417) 269-8811
Contract Pharmacy Representative
CVS Caremark
Anthony Gratto, 340B Vendor Manager
(401) 770-7298
Signed By Date
10/15/2013
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