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AMAZON PHARMACY #009
DSH520037 MARSHFIELD MEDICAL CENTER
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Covered Entity Details
Entity Name
MARSHFIELD MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH520037
Entity Address
611 St Joseph Avenue
MARSHFIELD, WI 54449
Medicare Provider Number
520037
Participating Start Date
1/1/2024
Last Recertification Date
9/5/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #009
Pharmacy Address
7469 KINGSPOINTE PKWY STE 400
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Robert Chaloner, President-Marshfield Medical Center-Marshfield/Neillsville
(715) 387-7855
Contract Pharmacy Representative
PillPack, LLC dba PillPack by Amazon Pharmacy
Bridget O'Connell, Managing Officer
(602) 793-8552
Signed By Date
1/15/2025
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