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MEDICAL PHARMACY MOORHEAD
CH050320 COMMUNITY HEALTH SERVICE INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH SERVICE INC.
Subdivision Name
Community Health Service Inc. Moorhead
Type
HRSA-Funded Health Center
340B ID
CH050320
Entity Address
2310 4th Ave N
Moorhead, MN 56560
Grant Number
H80CS00660
Participating Start Date
7/1/1999
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
MEDICAL PHARMACY MOORHEAD
Pharmacy Address
101 11TH ST S
MOORHEAD, MN 56560-2874
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristi Halvarson, Executive Director
(218) 422-7431
Contract Pharmacy Representative
MPND Inc
Sheila Nudell, Pharmacy manager
(218) 233-7365
Signed By Date
4/15/2016
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