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MISSOURI CVS PHARMACY, L.L.C.
DSH260183 SAINT FRANCIS MEDICAL CENTER
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Covered Entity Details
Entity Name
SAINT FRANCIS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260183
Entity Address
211 SAINT FRANCIS DRIVE
CAPE GIRARDEAU, MO 63703
Medicare Provider Number
260183
Participating Start Date
7/1/2010
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
MISSOURI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #18074
19 S KINGSHIGHWAY
CAPE GIRARDEAU, MO 63703-5742
Pharmacy Comments
Contract Details
Approval Date
4/4/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Ann Newcomer, Vice President - Regional Operations
(573) 331-5191
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/4/2025
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