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ACRO PHARMACEUTICAL SERVICES LLC
RRC140110-00 OTTAWA REGIONAL HOSPITAL & HEALTHCAR
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Covered Entity Details
Entity Name
OTTAWA REGIONAL HOSPITAL & HEALTHCAR
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140110-00
Entity Address
1100 EAST NORRIS DRIVE
OTTAWA, IL 61350
Medicare Provider Number
140110
Participating Start Date
7/1/2015
Last Recertification Date
9/5/2019
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
ACRO PHARMACEUTICAL SERVICES LLC
Pharmacy Address
ACRO PHARMACEUTICAL SERVICES LLC
313 HENDERSON DR
SHARON HILL, PA 19079
Pharmacy Comments
Contract Details
Approval Date
10/13/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/10/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Diane L. McGrew, President
(309) 655-2850
Contract Pharmacy Representative
Commcare Pharmacy
Avani Patel, Client Relations Manager
(954) 284-2358
Signed By Date
10/13/2016
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