340B Drug Pricing Program Database
ORCHARD DRUG
SCH130002-00 St. Luke's Magic Valley Regional Medical Center, LTD - information as of 4/27/2025 2:02:50 AM
Covered Entity Details
Entity Name
St. Luke's Magic Valley Regional Medical Center, LTD
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH130002-00
Entity Address
801 Pole Line Rd.West
Twin Falls, ID 83301
Medicare Provider Number
130002
Participating Start Date
7/1/2013
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
ORCHARD DRUG
Pharmacy Address
995 WASHINGTON ST S
TWIN FALLS, ID 83301
Pharmacy Comments
Contract Details
Approval Date
7/10/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter DiDio, Vice President, Controller
(208) 381-1251
Contract Pharmacy Representative
K2RED LLC
Daniel Fuchs, Member
(208) 878-6337
Signed By Date
7/10/2014
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