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DOC'S PHARMACY INC.
CH106300 BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.
Subdivision Name
BOUNDARY REGIONAL CHC
Type
HRSA-Funded Health Center
340B ID
CH106300
Entity Address
6615 COMANCHE ST
BONNERS FERRY, ID 83805
Grant Number
H80CS00302
Participating Start Date
10/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
DOC'S PHARMACY INC.
Pharmacy Address
MEDICINE MAN SANDPOINT
624 LARCH ST
SANDPOINT, ID 83864-8383
Pharmacy Comments
Contract Details
Approval Date
7/12/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/24/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
VICTORIA McCLELLAN KING, CEO
(208) 263-7101 Ext: 2202
Contract Pharmacy Representative
Doc's Pharmacy
Michelle Duhon, President
(208) 597-7466
Signed By Date
7/12/2013
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