340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
EVANS DRUG SEDALIA WEST LLC
DSH260009 BOTHWELL REGIONAL HEALTH CENTER
Print
Covered Entity Details
Entity Name
BOTHWELL REGIONAL HEALTH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260009
Entity Address
601 E. 14TH STREET
SEDALIA, MO 65301
Medicare Provider Number
260009
Participating Start Date
10/1/2023
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
EVANS DRUG SEDALIA WEST LLC
Pharmacy Address
1400 S LIMIT AVE, SUITE 3
SEDALIA, MO 65301
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/10/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Steven R Davis, Chief Financial Officer
(660) 829-7790
Contract Pharmacy Representative
Evans Drugs
Kevin McCullough, Owner
(417) 876-3313
Signed By Date
10/13/2023
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