340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BYRD-WATSON TIMES SQUARE DRUG
RRC140046-00 SSM HEALTH GOOD SAMARITAN HOSPITAL
Print
Covered Entity Details
Entity Name
SSM HEALTH GOOD SAMARITAN HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140046-00
Entity Address
1 GOOD SAMARITAN WAY
MT. VERNON, IL 62864
Medicare Provider Number
140046
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
BYRD-WATSON TIMES SQUARE DRUG
Pharmacy Address
3401 BROADWAY ST
MOUNT VERNON, IL 62864-2201
Pharmacy Comments
Contract Details
Approval Date
5/5/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eileen Lamm, Regional Vice President-Finance
(314) 994-6219
Contract Pharmacy Representative
ByrdWatson
Adam Breeze, Corporation Officer
(618) 244-5400 Ext: 129
Signed By Date
4/14/2025
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