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THOMPSON DEAN DRUG
CH070890 SIOUXLAND COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SIOUXLAND COMMUNITY HEALTH CENTER
Subdivision Name
SIOUXLAND COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH070890
Entity Address
1021 Nebraska St
Sioux City, IA 51105-1436
Grant Number
H80CS00535
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
THOMPSON DEAN DRUG
Pharmacy Address
911 W 7TH ST
SIOUX CITY, IA 51103
Pharmacy Comments
Contract Details
Approval Date
2/20/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHELLE STEPHAN, CEO
(712) 202-1011
Contract Pharmacy Representative
Thompson Dean Drug
GARY MALY, PRESIDENT
(712) 252-2761
Signed By Date
1/14/2013
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