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B & B DRUG
CAH061315-00 YUMA DISTRICT HOSPITAL
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Covered Entity Details
Entity Name
YUMA DISTRICT HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061315-00
Entity Address
1000 WEST 8TH AVENUE
YUMA, CO 80759
Medicare Provider Number
061315
Participating Start Date
10/1/2015
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
B & B DRUG
Pharmacy Address
BRUNNER ENTERPRISES, INC
149 MAIN AVE
AKRON, CO 80720
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Beth Saxton, CEO
(970) 848-4676
Contract Pharmacy Representative
B & B Drug Brunner Enterprises, Inc.
Ben Brunner, Owner
(970) 514-4433
Signed By Date
1/14/2020
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