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U-SAVE PHARMACY AND MEDICAL SUPPLY
CAH281340-00 DUNDY COUNTY HOSPITAL
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Covered Entity Details
Entity Name
DUNDY COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281340-00
Entity Address
1313 N CHEYENNE ST
BENKELMAN, NE 69021-3074
Medicare Provider Number
281340
Participating Start Date
1/1/2016
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
U-SAVE PHARMACY AND MEDICAL SUPPLY
Pharmacy Address
902 N HIGHWAY 83
MC COOK, NE 69001-2981
Pharmacy Comments
Contract Details
Approval Date
4/8/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/15/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rita A. Jones, CEO
(308) 423-2204 Ext: 2200
Contract Pharmacy Representative
U-save Pharmacy
Angela E. Langan, Owner
(308) 345-5670
Signed By Date
4/8/2021
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