340B Drug Pricing Program Database

Pharmacy Name

THE MEDICINE SHOPPE

Pharmacy Address

EDLUCY, INC.
1116 WEST MAIN STREET
FAIRFIELD, IL 62837

Pharmacy Comments

Approval Date

11/20/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/14/2016
Ownership change

Covered Entity Signing Official

Michael J. Brown, Chief Financial Officer
(618) 847-8260

Contract Pharmacy Representative

Ed Potts, Owner
(618) 842-3519

Signed By Date

10/10/2012