Contract Pharmacy Details

AURORA GRAND AVENUE PHARMACY
CH059030 COMMUNITY HEALTH SYSTEMS, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH SYSTEMS, INC.

Subdivision Name

Corporate Office

Type

HRSA-Funded Health Center

340B ID

CH059030

Entity Address

74 Eclipse Ctr
BELOIT, WI 53511-3550

Grant Number

H80CS00676

Participating Start Date

1/1/1999

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

AURORA GRAND AVENUE PHARMACY

Pharmacy Address

551 WEST GRAND AVENUE
BELOIT, WI 53511

Pharmacy Comments

Contract Details

Approval Date

1/1/1999

Contract Begin Date

1/1/1999

Carve-In Effective Date

Contract Comments

2/21/2006 - CORRECTION IN CONTRACT BEGIN DATE, INCORRECTLY GIVEN CONTRACT BEGIN DATE OF 10/1/1998 ORIGINALLY

Contract Termination Date
Termination Reason

1/1/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

340B Drug Pricing Program Database