340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KB OSCEOLA DRUG, LLC DBA EVANS DRUGS
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
KB OSCEOLA DRUG, LLC DBA EVANS DRUGS
Pharmacy Address
675 3RD ST
PO BOX 555
OSCEOLA, MO 64776
Pharmacy Comments
Contract Details
Approval Date
1/9/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lynnette Hayes, CNO
(660) 890-7167
Contract Pharmacy Representative
Evans Drugs
Kevin McCullough, Owner
(417) 276-3128
Signed By Date
1/9/2017
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