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ADENA CANCER CENTER PHARMACY
DSH360159 ADENA REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
ADENA REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360159
Entity Address
272 HOSPITAL ROAD
CHILLICOTHE, OH 45601
Medicare Provider Number
360159
Participating Start Date
4/1/2008
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ADENA CANCER CENTER PHARMACY
Pharmacy Address
DBA ADENA CANCER CENTER PHARMACY
4435 STATE ROUTE 159
CHILLICOTHE, OH 45601
Pharmacy Comments
Contract Details
Approval Date
2/14/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Dawn Bennett-Johnson, Interim CFO
(740) 779-7582
Contract Pharmacy Representative
Judith Henson, CNO
(740) 779-7151
Signed By Date
1/7/2013
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