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CHI HEALTH PHARMACY - LAKESIDE
CAH281346-00 ALEGENT CREIGHTON HEALTH d/b/a CHI Health Plainview
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Covered Entity Details
Entity Name
ALEGENT CREIGHTON HEALTH d/b/a CHI Health Plainview
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281346-00
Entity Address
704 N 3rd St
Plainview, NE 68769
Medicare Provider Number
281346
Participating Start Date
10/1/2011
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
CHI HEALTH PHARMACY - LAKESIDE
Pharmacy Address
16909 LAKESIDE HILLS CT STE 107
OMAHA, NE 68130-4661
Pharmacy Comments
Contract Details
Approval Date
10/23/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/11/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Greg Beckmann, President, Regional Hospital
(402) 582-4245 Ext: 1273
Contract Pharmacy Representative
CHI Health
Gregory Schardt, Division Director of Pharmacy Operations
(402) 206-3370
Signed By Date
10/23/2019
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