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FRANCISCAN PHARMACY OAKLAND
CAH281349-00 PENDER COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
PENDER COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281349-00
Entity Address
100 HOSPITAL DR
PENDER, NE 68047-0100
Medicare Provider Number
281349
Participating Start Date
1/1/2011
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
FRANCISCAN PHARMACY OAKLAND
Pharmacy Address
301 N OAKLAND AVE
OAKLAND, NE 68045
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Melissa Kelly, CFO/COO
(402) 385-4012
Contract Pharmacy Representative
Corner Drug Store
Richard Mulder, Owner
(402) 685-5883
Signed By Date
10/12/2018
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