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THRIFTY WHITE PHARMACY #793
DSH240187 HUTCHINSON HEALTH
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Covered Entity Details
Entity Name
HUTCHINSON HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH240187
Entity Address
1095 HIGHWAY 15 SOUTH
HUTCHINSON, MN 55350
Medicare Provider Number
240187
Participating Start Date
7/1/2017
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
THRIFTY WHITE PHARMACY #793
Pharmacy Address
1460 MONTREAL ST SE
HUTCHINSON, MN 55350-3318
Pharmacy Comments
Contract Details
Approval Date
10/12/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Pamela J. Larson, CFO
(320) 484-4472
Contract Pharmacy Representative
Thrifty White
Timothy Weippert, EVP of Pharmacy
(763) 513-4365
Signed By Date
10/12/2020
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