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CALCATERRA DRUG CO OF CARTERV
CH050040 SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION
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Covered Entity Details
Entity Name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORPORATION
Subdivision Name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT C
Type
HRSA-Funded Health Center
340B ID
CH050040
Entity Address
109 California St
Carterville, IL 62918-1923
Grant Number
H80CS00667
Participating Start Date
7/1/1998
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CALCATERRA DRUG CO OF CARTERV
Pharmacy Address
1205 S DIVISION ST
DBA FAMILY DRUGS
CARTERVILLE, IL 62918
Pharmacy Comments
Contract Details
Approval Date
8/29/2012
Contract Begin Date
8/29/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Patsy R. Jensen, CEO
(618) 985-8221
Contract Pharmacy Representative
Fred Calcaterra, President
(618) 985-2441
Signed By Date
8/16/2012
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