340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CUSTER PHARMACY
CAH361302-00 TRINITY HOSPITAL TWIN CITY
Print
Covered Entity Details
Entity Name
TRINITY HOSPITAL TWIN CITY
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH361302-00
Entity Address
819 N 1st STREET
DENNISON, OH 44621-1003
Medicare Provider Number
361302
Participating Start Date
7/1/2013
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CUSTER PHARMACY
Pharmacy Address
241 SOUTH MAIN STREET
CADIZ, OH 43907
Pharmacy Comments
Contract Details
Approval Date
10/2/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2018
Ownership change
Contacts
Covered Entity Signing Official
WOODROW W. HATHAWAY JR., CHIEF FINANCIAL OFFICER
(740) 922-7450 Ext: 2190
Contract Pharmacy Representative
Harrison Community Hospital
Jason Backel, Owner
(740) 942-2726
Signed By Date
10/2/2014
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