340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS INDIANA
CAH151333-00 PUTNAM COUNTY HOSPITAL
Print
Covered Entity Details
Entity Name
PUTNAM COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151333-00
Entity Address
1542 S BLOOMINGTON ST
GREENCASTLE, IN 46135-2297
Medicare Provider Number
151333
Participating Start Date
8/18/2010
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
CVS INDIANA
Pharmacy Address
7590 EMPIRE DR # 116-123
INDIANAPOLIS, IN 46219-1780
Pharmacy Comments
Contract Details
Approval Date
10/3/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DENNIS WEATHERFORD, CEO
(765) 301-7525 Ext: 7524
Contract Pharmacy Representative
CVS Rx Services, Inc
Jordan Birnbaum, 340B Vendor Manager
(401) 770-2241
Signed By Date
10/3/2014
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