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POWELL DRUG
CHC24102-00 BIGHORN VALLEY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
BIGHORN VALLEY HEALTH CENTER, INC
Subdivision Name
One Health - Bighorn
Type
HRSA-Funded Health Center
340B ID
CHC24102-00
Entity Address
10 West 4th Street STE B
Hardin, MT 59034-1804
Grant Number
H80CS24102
Participating Start Date
1/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
POWELL DRUG
Pharmacy Address
140 N BENT ST
POWELL, WY 82435
Pharmacy Comments
Contract Details
Approval Date
7/1/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David A. Mark, Chief Executive Officer
(406) 665-4103
Contract Pharmacy Representative
Powell Drug
David Klingler, Pharmacist
(307) 754-2031
Signed By Date
7/1/2022
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