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SIHF HEALTHCARE PHARMACY
CH053320 SIHF Healthcare
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Covered Entity Details
Entity Name
SIHF Healthcare
Subdivision Name
SIHF Healthcare
Type
HRSA-Funded Health Center
340B ID
CH053320
Entity Address
2041 Goose Lake Rd,
Sauget, IL 62206-2822
Grant Number
H80CS00195
Participating Start Date
7/1/2001
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
SIHF HEALTHCARE PHARMACY
Pharmacy Address
SOUTHERN ILLINOIS HEALTHCARE FOUNDATION,
1120 N EAST ST RM 105
OLNEY, IL 62450
Pharmacy Comments
Contract Details
Approval Date
10/12/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/16/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Larry McCulley, President
(618) 332-0694 Ext: 155
Contract Pharmacy Representative
Weber Medical Clinic Pharmacy
Emil Borowiak, Pharmacy Manager
(618) 395-8561 Ext: 14045
Signed By Date
10/12/2017
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