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SCHIEBER FAMILY PHARMACY
DSH360170 BERGER HOSPITAL
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Covered Entity Details
Entity Name
BERGER HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360170
Entity Address
600 N. PICKAWAY STREET
CIRCLEVILLE, OH 43113
Medicare Provider Number
360170
Participating Start Date
10/1/2009
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
SCHIEBER FAMILY PHARMACY
Pharmacy Address
212 LANCASTER PIKE
CIRCLEVILLE, OH 43113
Pharmacy Comments
Contract Details
Approval Date
10/5/2011
Contract Begin Date
10/5/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/29/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tim A. Colburn, President and CEO
(740) 420-8008
Contract Pharmacy Representative
SCHIEBER FAMILY PHARMACY
Larry Schieber, Owner/Pharmacist
(740) 474-1971
Signed By Date
9/25/2011
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