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SETZER PHARMACY
CH053020 WEST SIDE COMMUNITY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
WEST SIDE COMMUNITY HEALTH SERVICES, INC.
Subdivision Name
WESTSIDE COMMUNITY HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH053020
Entity Address
153 Cesar Chavez St
Saint Paul, MN 55107-2226
Grant Number
H80CS00790
Participating Start Date
1/1/1997
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
SETZER PHARMACY
Pharmacy Address
1685 RICE ST
ROSEVILLE, MN 55113
Pharmacy Comments
Contract Details
Approval Date
10/7/2022
Contract Begin Date
11/8/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Reuben Moore, President and Executive Officer
(651) 602-7536
Contract Pharmacy Representative
Lloyd's Pharmacy
Jim Stage, Owner
(507) 289-3901
Signed By Date
10/7/2022
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