340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KMART PHARMACY
CHC26610-00 HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Print
Covered Entity Details
Entity Name
HI-DESERT MEMORIAL HEALTH CARE DISTRICT
Subdivision Name
Morongo Basin Community Health Center-SR
Type
HRSA-Funded Health Center
340B ID
CHC26610-00
Entity Address
6380 Split Rock Ave
Twentynine Palms, CA 92277
Grant Number
H80CS26610
Participating Start Date
7/1/2015
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
KMART PHARMACY
Pharmacy Address
14011 PALM DRIVE
DESERT HOT SPRINGS, CA 92240
Pharmacy Comments
Contract Details
Approval Date
6/11/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/24/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
NORA MAUGHAN, EXECUTIVE DIRECTOR
(760) 366-6120
Contract Pharmacy Representative
Beth Zander, Director, Managed Care Services
(847) 286-7661
Signed By Date
6/11/2015
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