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FRANCISCAN PHARMACY
CAH281349-00 PENDER COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
PENDER COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281349-00
Entity Address
100 HOSPITAL DR
PENDER, NE 68047-0100
Medicare Provider Number
281349
Participating Start Date
1/1/2011
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
FRANCISCAN PHARMACY
Pharmacy Address
435 N MONITOR ST
WEST POINT, NE 68788
Pharmacy Comments
Contract Details
Approval Date
1/12/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/16/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Beth M Wewel, Chief Financial Officer
(402) 385-3083
Contract Pharmacy Representative
St. Francis Memorial Hospital
Michelle Borgmann, Pharmacist
(402) 372-6730
Signed By Date
1/12/2022
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