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THE MEDICINE SHOPPE
SCH140210-00 HARRISBURG MEDICAL CENTER INC.
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Covered Entity Details
Entity Name
HARRISBURG MEDICAL CENTER INC.
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH140210-00
Entity Address
100 DR WARREN TUTTLE DRIVE
HARRISBURG, IL 62946
Medicare Provider Number
140210
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
THE MEDICINE SHOPPE
Pharmacy Address
1315 W MAIN ST
MARION, IL 62959
Pharmacy Comments
Contract Details
Approval Date
7/11/2017
Contract Begin Date
3/15/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
June Hayes, CFO
(618) 253-0141
Contract Pharmacy Representative
Steve Ledbetter, Owner
(618) 926-7505
Signed By Date
7/11/2017
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