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TRUEPILL
CAH131319-01 Minidoka Memorial Hospital
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Covered Entity Details
Entity Name
Minidoka Memorial Hospital
Subdivision Name
Minidoka Medical - RHC
Type
Critical Access Hospital
340B ID
CAH131319-01
Entity Address
1308 8th Street 1
Rupert, ID 83350
Medicare Provider Number
131319
Outpatient Facility Provider Number
138507
Participating Start Date
10/1/2016
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
TRUEPILL
Pharmacy Address
3121 DIABLO AVE
HAYWARD, CA 94545
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jason Gibbons, CFO
(208) 436-8153
Contract Pharmacy Representative
Postmeds, Inc (dba Truepill)
Quynh Do, Pharmacist in Charge
(650) 353-5495
Signed By Date
1/15/2020
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