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PHARMACISTS ASSOCIATES LLC
CH0811510 SPECTRA HEALTH
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Covered Entity Details
Entity Name
SPECTRA HEALTH
Subdivision Name
Spectra Health Admin Office
Type
HRSA-Funded Health Center
340B ID
CH0811510
Entity Address
212 South 4th Street, Suite 200
Grand Forks, ND 58201-0160
Grant Number
H80CS01808
Participating Start Date
7/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PHARMACISTS ASSOCIATES LLC
Pharmacy Address
DBA NORTHWOOD DRUG
10 N MAIN ST
NORTHWOOD, ND 58267-4005
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mara Jiran, CEO
(701) 757-2802
Contract Pharmacy Representative
Pharmacists Associates LLC
Shane Wendel, Pharmacist
(701) 652-5810
Signed By Date
7/15/2020
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