340B Drug Pricing Program Database

Pharmacy Name

IOWA SPECIALTY PHARMACY

Pharmacy Address

215 13TH AVE SW
CLARION, IA 50525

Pharmacy Comments

Approval Date

11/20/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/1/2023
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Amy McDaniel, CFO
(515) 532-9285

Contract Pharmacy Representative

Iowa Specialty Hospital - Clarion
Christopher Medvec, Pharmacy Director
(641) 444-5660

Signed By Date

10/8/2012