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FIRST HEALTH SPECIALTY PHARMACY INC.
CH052700 SAWTOOTH MOUNTAIN CLINIC INC
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Covered Entity Details
Entity Name
SAWTOOTH MOUNTAIN CLINIC INC
Subdivision Name
SAWTOOTH MOUNTAIN CLINIC
Type
HRSA-Funded Health Center
340B ID
CH052700
Entity Address
513 5th Ave W
Grand Marais, MN 55604-3017
Grant Number
H80CS00496
Participating Start Date
1/1/2004
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
FIRST HEALTH SPECIALTY PHARMACY INC.
Pharmacy Address
754 E 151ST ST
BRONX, NY 10455-3267
Pharmacy Comments
Contract Details
Approval Date
7/12/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
RITA M. PLOURDE, CEO
(218) 387-2330
Contract Pharmacy Representative
First Health Specialty Pharmacy Inc.
Emil Trokel, President
(347) 783-7070
Signed By Date
7/12/2018
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