340B Drug Pricing Program Database
CHURCHILL PHARMACY
DSH350015 SANFORD BISMARCK - information as of 4/25/2025 5:58:42 PM
Covered Entity Details
Entity Name
SANFORD BISMARCK
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH350015
Entity Address
300 N 7TH ST
BISMARCK, ND 58501
Medicare Provider Number
350015
Participating Start Date
7/1/2016
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CHURCHILL PHARMACY
Pharmacy Address
1190 W TURNPIKE AVE
STE 2
BISMARCK, ND 58501
Pharmacy Comments
Contract Details
Approval Date
1/10/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kirk Cristy, Vice President Finance
(701) 323-6000 Ext: 6310
Contract Pharmacy Representative
Churchill Pharmacy
Dan Churchill, Owner
(701) 224-0339
Signed By Date
1/10/2017
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