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PLAZA PHARMACY INC
SCH170023-01 St. Catherine Hospital - Garden City
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Covered Entity Details
Entity Name
St. Catherine Hospital - Garden City
Subdivision Name
SIENA MEDICAL CLINIC
Type
Sole Community Hospital
340B ID
SCH170023-01
Entity Address
311 E Spruce St
Garden City, KS 67846
Medicare Provider Number
170023
Outpatient Facility Provider Number
Participating Start Date
9/15/2010
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
PLAZA PHARMACY INC
Pharmacy Address
911 N MAIN ST
GARDEN CITY, KS 67846-5561
Pharmacy Comments
Contract Details
Approval Date
11/28/2012
Contract Begin Date
11/28/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John Yox, VP
(620) 272-2563
Contract Pharmacy Representative
Jennifer Schmitt, Owner
(620) 276-8251
Signed By Date
9/28/2012
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