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SUTTON PHARMACY, LLC
CAH281308-00 HENDERSON HEALTH CARE SERVICES
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Covered Entity Details
Entity Name
HENDERSON HEALTH CARE SERVICES
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281308-00
Entity Address
1621 FRONT ST.
HENDERSON, NE 68371
Medicare Provider Number
281308
Participating Start Date
10/1/2014
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
SUTTON PHARMACY, LLC
Pharmacy Address
SUTTON PHARMACY
210 N SAUNDERS AVE
PO BOX 445
SUTTON, NE 68979
Pharmacy Comments
Contract Details
Approval Date
8/7/2019
Contract Begin Date
8/7/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Cheryl Brown, CEO
(402) 723-4512 Ext: 4014
Contract Pharmacy Representative
B & C Drug Company
Kevin L. Couture, President
(785) 527-2146
Signed By Date
8/7/2019
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