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REM CORPORATION
DSH150074 Community Health Network, Inc.
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Covered Entity Details
Entity Name
Community Health Network, Inc.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH150074
Entity Address
1500 N. RITTER AVE.
INDIANAPOLIS, IN 46219
Medicare Provider Number
150074
Participating Start Date
4/1/2008
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
REM CORPORATION
Pharmacy Address
DBA COMMUNITY MEDICAL CENTER PHARM
1311 N. ARLINGTON AVE.
SUITE 101
INDIANAPOLIS, IN 46219
Pharmacy Comments
Contract Details
Approval Date
12/6/2010
Contract Begin Date
12/6/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
ANTHONY RATTINI, PRESIDENT
(937) 743-7775
Signed By Date
9/30/2010
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