340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ST JOHN PHARMACY
DSH230165M ST JOHN HOSPITAL & MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ST JOHN HOSPITAL & MEDICAL CENTER
Subdivision Name
MEDICAL PAVILION TWO
Type
Disproportionate Share Hospital
340B ID
DSH230165M
Entity Address
7633 E. JEFFERSON
DETROIT, MI 48214
Medicare Provider Number
230165
Outpatient Facility Provider Number
Participating Start Date
1/1/2008
Last Recertification Date
8/31/2015
Entity Termination Date
7/1/2016
Pharmacy Details
Pharmacy Name
ST JOHN PHARMACY
Pharmacy Address
7633 EAST JEFFERSON
SUITE #130
DETROIT, MI 48214
Pharmacy Comments
Contract Details
Approval Date
1/4/2008
Contract Begin Date
1/4/2008
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2016
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
1/4/2008
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