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ASTRUP DRUG INC
DSH240022 SANFORD WORTHINGTON MEDICAL CENTER
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Covered Entity Details
Entity Name
SANFORD WORTHINGTON MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH240022
Entity Address
1018 6TH AVENUE
WORTHINGTON, MN 56187-0097
Medicare Provider Number
240022
Participating Start Date
1/1/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
ASTRUP DRUG INC
Pharmacy Address
STERLING DRUG #8
511 10TH ST.
WORTHINGTON, MN 56187
Pharmacy Comments
Contract Details
Approval Date
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Thomas Cleveland, Director of Finance
(605) 312-9351
Contract Pharmacy Representative
Sterling Drug
Joe Anderson, Pharmacy Manager
(507) 372-7533
Signed By Date
1/14/2019
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