Contract Pharmacy Details

MEDICINE EXPRESS
CH05332CA SIHF Healthcare

Covered Entity Details

Entity Name

SIHF Healthcare

Subdivision Name

Belleville Family Health Center II

Type

HRSA-Funded Health Center

340B ID

CH05332CA

Entity Address

211 S 3rd St
Belleville, IL 62220-1915

Grant Number

H80CS00195

Participating Start Date

10/1/2009

Last Recertification Date

2/9/2018

Entity Termination Date

10/1/2018

Pharmacy Details

Pharmacy Name

MEDICINE EXPRESS

Pharmacy Address

1704 NORTH ILLINOIS
SUITE 200
SWANSEA, IL 62226

Pharmacy Comments

Contract Details

Approval Date

6/21/2012

Contract Begin Date

6/21/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2018
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Larry McCulley, President
(618) 332-0694 Ext: 155

Contract Pharmacy Representative

Richard Sprehe, Owner
(618) 236-1144

Signed By Date

6/4/2012