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CENTERWELL PHARMACY, INC.
CAH151332-00 DECATUR COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
DECATUR COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151332-00
Entity Address
720 NORTH LINCOLN STREET
GREENSBURG, IN 47240
Medicare Provider Number
151332
Participating Start Date
8/18/2010
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
CENTERWELL PHARMACY, INC.
Pharmacy Address
11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDO, FL 32824
Pharmacy Comments
Contract Details
Approval Date
4/4/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rex McKinney, CEO
(812) 663-1171
Contract Pharmacy Representative
CenterWell Pharmacy
Jay Duprey, ASSOCIATE DIRECTOR, CHANNEL DEVELOPMENT
(248) 921-7578
Signed By Date
4/4/2024
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