340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ADVANCED PHARMACY, LLC
CAH171331-00 KIOWA DISTRICT HOSPITAL
Print
Covered Entity Details
Entity Name
KIOWA DISTRICT HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171331-00
Entity Address
1002 South 4th Street
KIOWA, KS 67070-0184
Medicare Provider Number
171331
Participating Start Date
7/1/2015
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
ADVANCED PHARMACY, LLC
Pharmacy Address
ADVANCED PHARMACY
350 FEASTER ROAD
SUITE D
GREENVILLE, SC 29615-6176
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
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
Janell Goodno, CFO
(620) 825-4131 Ext: 1001
Contract Pharmacy Representative
Gregory P. Santulli, President
(770) 339-1190 Ext: 7063
Signed By Date
4/15/2016
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