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PHARMACY PLUS
DSH260183 SAINT FRANCIS MEDICAL CENTER
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Covered Entity Details
Entity Name
SAINT FRANCIS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260183
Entity Address
211 SAINT FRANCIS DRIVE
CAPE GIRARDEAU, MO 63703
Medicare Provider Number
260183
Participating Start Date
7/1/2010
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
PHARMACY PLUS
Pharmacy Address
150 S MT AUBURN RD STE 107
CAPE GIRARDEAU, MO 63703
Pharmacy Comments
Contract Details
Approval Date
8/6/2010
Contract Begin Date
8/6/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/18/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
STEVEN C. BJELICH, PRESIDENT AND CEO
(573) 331-5128
Contract Pharmacy Representative
Saint Francis Medical Center
SARAH JANE MIRGAUX, DIRECTOR OF PHARMACY
(573) 331-5251
Signed By Date
7/19/2010
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