340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MOHRMANN'S DRUG STORE LLC
DSH450235 GONZALES HEALTHCARE SYSTEMS
Print
Covered Entity Details
Entity Name
GONZALES HEALTHCARE SYSTEMS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450235
Entity Address
1110 N SARAH DEWITT DRIVE
GONZALES, TX 78629
Medicare Provider Number
450235
Participating Start Date
10/1/2004
Last Recertification Date
9/2/2019
Entity Termination Date
5/6/2020
Pharmacy Details
Pharmacy Name
MOHRMANN'S DRUG STORE LLC
Pharmacy Address
2405 WINDING WAY DR
GONZALES, TX 78629
Pharmacy Comments
Contract Details
Approval Date
8/20/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/6/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
CHUCK NORRIS, ADMINISTRATOR
(830) 672-7581 Ext: 1001
Contract Pharmacy Representative
Mohrmann's Drug Store
John Mohrmann, Owner
(830) 672-2317
Signed By Date
8/20/2014
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