340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MISSOURI CVS PHARMACY, L.L.C.
SCH260025-00 HANNIBAL REGIONAL HOSPITAL
Print
Covered Entity Details
Entity Name
HANNIBAL REGIONAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH260025-00
Entity Address
6000 HOSPITAL DRIVE
HANNIBAL, MO 63401
Medicare Provider Number
260025
Participating Start Date
10/1/2023
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #11314
1105 N RUTHERFORD ST
MACON, MO 63552
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rob Gasaway, VP-Finance/CFO
(573) 406-1608
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/5/2024
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