340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HEALTHCARE PHARMACY
CH074020 CROSS TRAILS MEDICAL CENTER
Print
Covered Entity Details
Entity Name
CROSS TRAILS MEDICAL CENTER
Subdivision Name
CROSS TRAILS MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH074020
Entity Address
408 S Broadview St
Cape Girardeau, MO 63703-5725
Grant Number
H80CS00211
Participating Start Date
10/1/1998
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
HEALTHCARE PHARMACY
Pharmacy Address
HEALTHCARE PHARMACY
628 OLD SAINT MARYS RD
P.O. BOX 469
PERRYVILLE, MO 63775-6377
Pharmacy Comments
Contract Details
Approval Date
1/5/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2017
Ownership change
Contacts
Covered Entity Signing Official
Ron Camp, CEO
(573) 339-1196
Contract Pharmacy Representative
Barry J. Naeger, President
(573) 547-2517
Signed By Date
1/5/2015
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