340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MEDICINE SHOPPE
CAH501337-00 LOURDES MEDICAL CENTER
Print
Covered Entity Details
Entity Name
LOURDES MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH501337-00
Entity Address
520 N 4TH AVENUE
PASCO, WA 99301
Medicare Provider Number
501337
Participating Start Date
1/1/2011
Last Recertification Date
11/15/2017
Entity Termination Date
10/1/2018
Pharmacy Details
Pharmacy Name
MEDICINE SHOPPE
Pharmacy Address
1121 W COURT ST
PASCO, WA 99301
Pharmacy Comments
Contract Details
Approval Date
4/20/2012
Contract Begin Date
4/20/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tracy Sue Clark, Director of Pharmacy
(509) 546-2298
Contract Pharmacy Representative
Chriselda Gamino, Owner
(509) 547-7537
Signed By Date
4/3/2012
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