Pharmacy Details

MEDICINE MAN PHARMACY INC - information as of 5/9/2025 12:48:40 AM

Name
MEDICINE MAN PHARMACY INC

Address

1114 W IRONWOOD DR
COEUR D ALENE, ID 83814-2605

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	DSH130049	KOOTENAI HEALTH INC	KOOTENAI HEALTH	Disproportionate Share Hospital	2003 Kootenai Health Way		COEUR DALENE	ID	10/01/2014	04/01/2019	4/1/2019 12:05 AM
Details	RRC130049-00	KOOTENAI HEALTH INC		Rural Referral Center	2003 KOOTENAI HEALTH WAY		COEUR DALENE	ID	04/01/2019	07/01/2021	7/1/2021 12:01 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			MEDICINE MAN PHARMACY INC 1114 W IRONWOOD DR COEUR D ALENE, ID 83814-2605	1/4/2021 4:48 PM
Addresses	Pharmacy Address	Insert			MEDICINE MAN PHARMACY INC 1114 IRONWOOD DRIVE COEUR D ALENE, ID 83814-2605	12/18/2020 4:27 PM
Addresses	Pharmacy Address	Insert			MEDICINE MAN PHARMACY INC 1114 IRONWOOD DRIVE COEUR D ALENE, ID 83814	9/29/2017 6:44 AM
Addresses	Pharmacy Address	Update		MEDICINE MAN PHARMACY INC 1114 IRONWOOD DRIVE COEUR D'ALENE, ID 83814	MEDICINE MAN PHARMACY INC 1114 IRONWOOD DRIVE COEUR D ALENE, ID 83814	12/23/2014 3:40 PM
Details	Comments	Update				3/28/2013 4:29 PM
Addresses	Pharmacy Address	Update		Medicine Man Pharmacy, Inc. 1114 Ironwood Drive Coeur d'Alene, ID 83814	MEDICINE MAN PHARMACY INC 1114 IRONWOOD DRIVE COEUR D'ALENE, ID 83814	3/13/2013 2:54 PM
Details	Name	Update		Medicine Man Pharmacy, Inc.	MEDICINE MAN PHARMACY INC	3/13/2013 2:54 PM
Details	Comments	Insert				1/11/2013 8:07 AM
Details	Is Deleted	Insert			False	1/11/2013 8:07 AM
Addresses	Pharmacy Address	Insert			Medicine Man Pharmacy, Inc. 1114 Ironwood Drive Coeur d'Alene, ID 83814	1/11/2013 8:07 AM