340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MERCY HOSPITAL & MEDICAL CENTER
DSH140158J MERCY HOSPITAL AND MEDICAL CENTER
Print
Covered Entity Details
Entity Name
MERCY HOSPITAL AND MEDICAL CENTER
Subdivision Name
MICHIGAN AVENUE
Type
Disproportionate Share Hospital
340B ID
DSH140158J
Entity Address
2930 S. MICHIGAN AVENUE
SUITE 108
CHICAGO, IL 60616
Medicare Provider Number
140158
Outpatient Facility Provider Number
Participating Start Date
7/1/2004
Last Recertification Date
8/24/2020
Entity Termination Date
7/1/2021
Pharmacy Details
Pharmacy Name
MERCY HOSPITAL & MEDICAL CENTER
Pharmacy Address
DEPARTMENT OF PHARMACY SERVICES
2525 S. MICHIGAN AVENUE
CHICAGO, IL 60616-2477
Pharmacy Comments
Contract Details
Approval Date
8/1/2005
Contract Begin Date
8/1/2005
Carve-In Effective Date
Contract Comments
4/23/08 ADMIN CORRECTION 340B ID # CHANGED (WAS DSH60616J)
Contract Termination Date
Termination Reason
7/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
7/27/2005
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