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THE CORNER DRUG STORE
SCH190088-00 SPRINGHILL MEDICAL CENTER - AMENDED
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Covered Entity Details
Entity Name
SPRINGHILL MEDICAL CENTER - AMENDED
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH190088-00
Entity Address
2001 DOCTORS DRIVE
SPRINGHILL, LA 71075
Medicare Provider Number
190088
Participating Start Date
1/1/2018
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
THE CORNER DRUG STORE
Pharmacy Address
27 REYNOLDS ST
SPRINGHILL, LA 71075
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vincent R Sedminik, CEO
(318) 539-1001
Contract Pharmacy Representative
The Corner Drug Store
James Duck, Owner
(318) 539-3199
Signed By Date
1/12/2018
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