340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DISCOUNT DRUG MART #61
SCH360125-00 Ashtabula County Medical Center
Print
Covered Entity Details
Entity Name
Ashtabula County Medical Center
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH360125-00
Entity Address
2420 Lake Avenue
Ashtabula, OH 44004
Medicare Provider Number
360125
Participating Start Date
1/1/2012
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
DISCOUNT DRUG MART #61
Pharmacy Address
107 SOUTH CHESTNUT ST
JEFFERSON, OH 44047
Pharmacy Comments
Contract Details
Approval Date
4/23/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald L. Kepner, Chief Financial Officer
(440) 997-6912
Contract Pharmacy Representative
Discount Drug Mart
Pete Ratycz, Vice President of Pharmacy
(330) 725-2340
Signed By Date
4/23/2013
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