Contract Pharmacy Details

MARTINS PHARMACY
CH05332BZ SIHF Healthcare

Covered Entity Details

Entity Name

SIHF Healthcare

Subdivision Name

SIHF Healthcare - Greenup

Type

HRSA-Funded Health Center

340B ID

CH05332BZ

Entity Address

302 N Mill St
Greenup, IL 62428-1062

Grant Number

H80CS00195

Participating Start Date

4/1/2008

Last Recertification Date

2/22/2025

Pharmacy Details

Pharmacy Name

MARTINS PHARMACY

Pharmacy Address

101 S MERCHANT
EFFINGHAM, IL 62401

Pharmacy Comments

Contract Details

Approval Date

2/27/2012

Contract Begin Date

2/27/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Larry McCulley, President
(618) 332-0694

Contract Pharmacy Representative

Courtney Carr, Pharmacy Manager
(618) 342-4301

Signed By Date

2/23/2012