340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BEN'S FAMILY PHARMACY
CAH061313-00 KIT CARSON COUNTY MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
KIT CARSON COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061313-00
Entity Address
286 16TH STREET
BURLINGTON, CO 80807
Medicare Provider Number
061313
Participating Start Date
4/1/2019
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
BEN'S FAMILY PHARMACY
Pharmacy Address
DBA HONEST OAK LLC
333 M AVE STE 100
LIMON, CO 80828
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
1/31/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Susan Vaughan, CNO
(719) 346-5311 Ext: 2510
Contract Pharmacy Representative
Ben's Family Pharmacy
Benjamin Ferree, Owner
(719) 775-0500
Signed By Date
1/15/2020
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