340B Drug Pricing Program Database

Pharmacy Name

ASCENSION VIA CHRISTI HOME MEDICAL WICHI

Pharmacy Address

528 N SAINT FRANCIS ST
WICHITA, KS 67214-3808

Pharmacy Comments

Approval Date

9/20/2012

Contract Begin Date

9/20/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/8/2015
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Michael A. Wegner, Senior VP of Finance & CFO
(316) 268-8525

Contract Pharmacy Representative

Joy M. Scott, Executive Director
(316) 858-2112

Signed By Date

8/29/2012