340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OHIO CVS STORES, L.L.C.
DSH360189 MADISON HEALTH
Print
Covered Entity Details
Entity Name
MADISON HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360189
Entity Address
210 NORTH MAIN STREET
LONDON, OH 43140
Medicare Provider Number
360189
Participating Start Date
1/1/2011
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
OHIO CVS STORES, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06191
214 LAFAYETTE ST.
LONDON, OH 43140
Pharmacy Comments
Contract Details
Approval Date
9/20/2012
Contract Begin Date
9/20/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/19/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael S. Browning, Interim Chief Executive Officer
(740) 845-7015
Contract Pharmacy Representative
CVS
Scott Tierney, Senior Director, Payer Relations
(401) 770-2762
Signed By Date
8/28/2012
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