340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SWEET SPRINGS PHARMACY INC
DSH260142D JOHN FITZGIBBON MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
JOHN FITZGIBBON MEMORIAL HOSPITAL
Subdivision Name
JOHN FITZGIBBON HOSPITAL INC - Pilot Grove Medical Clinic
Type
Disproportionate Share Hospital
340B ID
DSH260142D
Entity Address
212 COLLEGE ST
PILOT GROVE MEDICAL CLINIC AT FITZG
PILOT GROVE, MO 65276-1005
Medicare Provider Number
260142
Outpatient Facility Provider Number
268790
Participating Start Date
1/1/2024
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
SWEET SPRINGS PHARMACY INC
Pharmacy Address
401 S LOCUST ST
SWEET SPRINGS, MO 65351
Pharmacy Comments
Contract Details
Approval Date
11/2/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Angy P. Littrell, President & CEO
(660) 831-3251
Contract Pharmacy Representative
The Market
Tony Clark, Director of Operations
(660) 247-1580
Signed By Date
10/5/2023
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