340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MEDI-PARK PHARMACY
DSH140052 OSF SAINT ANTHONY'S HEALTH CENTER
Print
Covered Entity Details
Entity Name
OSF SAINT ANTHONY'S HEALTH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140052
Entity Address
1 SAINT ANTHONYS WAY
ALTON, IL 62002
Medicare Provider Number
140052
Participating Start Date
3/15/2022
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
MEDI-PARK PHARMACY
Pharmacy Address
420 NE GLEN OAK AVE STE 102
HILLCREST PLAZA
PEORIA, IL 61603-3171
Pharmacy Comments
Contract Details
Approval Date
4/14/2017
Contract Begin Date
3/15/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/15/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Diane L. McGrew, President
(309) 655-2850
Contract Pharmacy Representative
Greg Puszkiewicz, Director Retail Pharmacy Services
(309) 624-8777
Signed By Date
4/14/2017
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