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DOYLE HIGH'S THE DRUG STORE
CAH451341-00 HASKELL MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
HASKELL MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH451341-00
Entity Address
1 AVENUE N
HASKELL, TX 79521-1117
Medicare Provider Number
451341
Participating Start Date
1/1/2015
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
DOYLE HIGH'S THE DRUG STORE
Pharmacy Address
100 S AVENUE E
HASKELL, TX 79521-5711
Pharmacy Comments
Contract Details
Approval Date
12/15/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Fran McCown, CEO
(940) 864-2621 Ext: 305
Contract Pharmacy Representative
Lonnie Meredith, Pharmacist
(940) 864-2673
Signed By Date
12/15/2014
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