340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MR DISCOUNT DRUGS OF BUTLER
CAH011304-00 Choctaw General Hospital
Print
Covered Entity Details
Entity Name
Choctaw General Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH011304-00
Entity Address
401 Vanity Fair Lane
Butler, AL 36904
Medicare Provider Number
011304
Participating Start Date
7/1/2013
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
MR DISCOUNT DRUGS OF BUTLER
Pharmacy Address
604 E PUSHMATAHA ST
BUTLER, AL 36904-2620
Pharmacy Comments
Contract Details
Approval Date
1/6/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/17/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
J. W. Cowan, Administrator
(205) 459-9175
Contract Pharmacy Representative
Greg Manley, Owner
(205) 459-2990
Signed By Date
1/6/2014
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