340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ELMWOOD PHARMACY
RWIID685091 NEBRASKA DEPT OF HEALTH & HUMAN SERVICES
Print
Covered Entity Details
Entity Name
NEBRASKA DEPT OF HEALTH & HUMAN SERVICES
Subdivision Name
DIVISION OF SERVICES
Type
Ryan White Part B ADAP Direct Purchase
340B ID
RWIID685091
Entity Address
301 CENTENNIAL MALL S., 3RD FL
LINCOLN, NE 68509-5026
Grant Number
X07HA00042
Participating Start Date
4/1/1997
Last Recertification Date
2/5/2021
Entity Termination Date
7/1/2021
Pharmacy Details
Pharmacy Name
ELMWOOD PHARMACY
Pharmacy Address
KILBORNS INC. DBA ELMWOOD PHARMACY
5203 LEAVENWORTH ST
OMAHA, NE 68106
Pharmacy Comments
Contract Details
Approval Date
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
STEPHEN G JACKSON, RYAN WHITE PROGRAM MANAGER
(402) 471-2504
Contract Pharmacy Representative
Elmwood Pharmacy
Jeffrey Kilborn, President
(402) 551-5200
Signed By Date
7/13/2017
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