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SKIP'S BUDGET DRUG
SCH350019-00 ALTRU HOSPITAL
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Covered Entity Details
Entity Name
ALTRU HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH350019-00
Entity Address
1200 SOUTH COLUMBIA ROAD
GRAND FORKS, ND 58201
Medicare Provider Number
350019
Participating Start Date
8/5/2010
Last Recertification Date
9/11/2024
Pharmacy Details
Pharmacy Name
SKIP'S BUDGET DRUG
Pharmacy Address
2015 LIBRARY CIR STE 102
GRAND FORKS, ND 58201
Pharmacy Comments
Contract Details
Approval Date
4/12/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janice Hamscher, Chief Nursing Officer
(701) 780-3403
Contract Pharmacy Representative
Budget Drug
Isaac Aasen, PharmD
(701) 430-1485
Signed By Date
4/12/2019
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