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FAMILY PHARMACY OF MOBRIDGE
CH08103T HORIZON HEALTH CARE INC
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Covered Entity Details
Entity Name
HORIZON HEALTH CARE INC
Subdivision Name
MCINTOSH COMMUNITY CLINIC
Type
HRSA-Funded Health Center
340B ID
CH08103T
Entity Address
208 MAIN ST
MCINTOSH, SD 57641-7707
Grant Number
H80CS00135
Participating Start Date
7/1/2016
Last Recertification Date
2/19/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
FAMILY PHARMACY OF MOBRIDGE
Pharmacy Address
FAMILY PHARMACY OF MOBRIDGE, INC
323 N MAIN ST
MOBRIDGE, SD 57601
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
5/8/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Melissa Hofer, Chief Financial Officer
(605) 772-4525
Contract Pharmacy Representative
Family Pharmacy
Sarah Andersen, Owner
(605) 845-3345
Signed By Date
4/17/2023
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