Contract Pharmacy Details

CORVALLIS DRUG
CHC28359-00 SAPPHIRE COMMUNITY HEALTH, INC.

Covered Entity Details

Entity Name

SAPPHIRE COMMUNITY HEALTH, INC.

Subdivision Name

Sapphire Community Health

Type

HRSA-Funded Health Center

340B ID

CHC28359-00

Entity Address

316 N.3rd St.
Hamilton, MT 59840-2405

Grant Number

H80CS28359

Participating Start Date

4/1/2016

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

CORVALLIS DRUG

Pharmacy Address

1029 MAIN ST
P.O. BOX 9
CORVALLIS, MT 59828-9374

Pharmacy Comments

Contract Details

Approval Date

2/10/2021

Contract Begin Date

2/10/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Janet Woodburn, Interim Chief Executive Officer
(406) 541-0475

Contract Pharmacy Representative

Corvallis Drug
Kyp Curtis, President
(406) 363-9003

Signed By Date

2/10/2021

340B Drug Pricing Program Database