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MEIJER PHARMACY #117
DSH360068 THE TOLEDO HOSPITAL
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Covered Entity Details
Entity Name
THE TOLEDO HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360068
Entity Address
2142 N. COVE BLVD.
TOLEDO, OH 43606
Medicare Provider Number
360068
Participating Start Date
4/1/2007
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
MEIJER PHARMACY #117
Pharmacy Address
7240 W. CENTRAL AVENUE
TOLEDO, OH 43617-1119
Pharmacy Comments
Contract Details
Approval Date
1/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Scott Fought, CFO, Providers, Acute & Ambulatory Care
(567) 585-5909
Contract Pharmacy Representative
Meijer
Kevin Hurn, Dir, Pharmacy Procurement and New Business
(616) 791-5185
Signed By Date
1/17/2017
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