340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ESTHERVILLE PHARMACY
CAH161351-00 Avera Holy Family Health
Print
Covered Entity Details
Entity Name
Avera Holy Family Health
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161351-00
Entity Address
826 N 8TH ST
ESTHERVILLE, IA 51334
Medicare Provider Number
161351
Participating Start Date
9/30/2010
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
ESTHERVILLE PHARMACY
Pharmacy Address
1804 E CENTRAL AVE
ESTHERVILLE, IA 51334
Pharmacy Comments
Contract Details
Approval Date
7/6/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steve Petersen, Vice President of Pharmacy
(605) 322-8313
Contract Pharmacy Representative
Rex Pharmacy, Inc.
Joshua M Borer, President
(712) 243-2110
Signed By Date
7/6/2020
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