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THE PHARMACY AT APPLE MARKET NORTH
SCH260006-00 HEARTLAND REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
HEARTLAND REGIONAL MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH260006-00
Entity Address
5325 FARAON
ST. JOSEPH, MO 64506-3398
Medicare Provider Number
260006
Participating Start Date
10/1/2020
Last Recertification Date
8/30/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
THE PHARMACY AT APPLE MARKET NORTH
Pharmacy Address
WHEEL'S PHARMACY,LLC
903 N 36TH ST
SAINT JOSEPH, MO 64506-2971
Pharmacy Comments
Contract Details
Approval Date
8/13/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/17/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John P. Wilson, Chief Financial Officer
(816) 271-6611
Contract Pharmacy Representative
Wheel's Pharmacy
Jerome Wheeler, Owner & Pharmacist
(816) 260-6346
Signed By Date
8/13/2015
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