340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MERRYFIELD PHARMACY INC
RRC260175-00 GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT
Print
Covered Entity Details
Entity Name
GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT
Subdivision Name
Type
Rural Referral Center
340B ID
RRC260175-00
Entity Address
1600 NORTH SECOND STREET
CLINTON, MO 64735
Medicare Provider Number
260175
Participating Start Date
9/29/2010
Last Recertification Date
8/31/2020
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
MERRYFIELD PHARMACY INC
Pharmacy Address
200 W BENTON ST.
WINDSOR, MO 65360
Pharmacy Comments
Contract Details
Approval Date
7/13/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Mark Mattes, CNO
(660) 890-7167
Contract Pharmacy Representative
Merryfield Pharmacy
Lindsay Merryfield, Co-Owner
(660) 647-2101
Signed By Date
7/13/2015
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