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EVANS DRUGS
CAH261323-00 CEDAR COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
CEDAR COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH261323-00
Entity Address
1401 S. PARK STREET
EL DORADO SPRINGS, MO 64744
Medicare Provider Number
261323
Participating Start Date
9/8/2010
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
EVANS DRUGS
Pharmacy Address
KB EVANS DRUGS
209 E US HIGHWAY 54
EL DORADO SPRINGS, MO 64744-1925
Pharmacy Comments
Contract Details
Approval Date
7/18/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANA WITT, CEO
(417) 876-2511
Contract Pharmacy Representative
Evans Drugs
Kevin McCullough, Owner
(417) 276-3128
Signed By Date
7/18/2013
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