340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CLINIC PHARMACY
CAH351333-00 Mercy Hospital of Devils Lake d/ba/ CHI St. Alexius Health Devils Lake Hospital
Print
Covered Entity Details
Entity Name
Mercy Hospital of Devils Lake d/ba/ CHI St. Alexius Health Devils Lake Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH351333-00
Entity Address
1031 7th St NE
Devils Lake, ND 58301-2798
Medicare Provider Number
351333
Participating Start Date
9/29/2010
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
CLINIC PHARMACY
Pharmacy Address
1001 7TH ST NE
P.O. BOX 1100
DEVILS LAKE, ND 58301
Pharmacy Comments
Contract Details
Approval Date
1/8/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/4/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Andrew Joseph Lankowicz, President
(701) 662-9710
Contract Pharmacy Representative
Clinic Pharmacy
Becky Fletschock, Owner
(701) 662-4427
Signed By Date
1/8/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session