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BEULAH DRUG
CH081150C COAL COUNTRY COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
COAL COUNTRY COMMUNITY HEALTH CENTER
Subdivision Name
CENTER CLINIC
Type
HRSA-Funded Health Center
340B ID
CH081150C
Entity Address
111 MAIN ST
CENTER, ND 58530
Grant Number
H80CS09469
Participating Start Date
4/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BEULAH DRUG
Pharmacy Address
147 W MAIN ST
BEULAH, ND 58523-6969
Pharmacy Comments
Contract Details
Approval Date
6/23/2004
Contract Begin Date
6/23/2004
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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