Contract Pharmacy Details

NOVIXUS PHARMACY SERVICES
CAH191326-00 REEVES MEMORIAL MEDICAL CENTER

Covered Entity Details

Entity Name

REEVES MEMORIAL MEDICAL CENTER

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH191326-00

Entity Address

409 FIRST ST.
BERNICE, LA 71222

Medicare Provider Number

191326

Participating Start Date

1/1/2018

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

NOVIXUS PHARMACY SERVICES

Pharmacy Address

43159 WEST NINE MILE ROAD
NOVI, MI 48376

Pharmacy Comments

Contract Details

Approval Date

4/16/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/31/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Kerry D Goff, CEO
(318) 285-7762

Contract Pharmacy Representative

Novixus Pharmacy Services
Richard Grossman, Vice President of Pharmacy Services
(248) 380-2105

Signed By Date

4/16/2018

340B Drug Pricing Program Database