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FAMILY PHARMACY OF MOBRIDGE
CH08103U HORIZON HEALTH CARE INC
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Covered Entity Details
Entity Name
HORIZON HEALTH CARE INC
Subdivision Name
HORIZON HEALTH - ISABEL
Type
HRSA-Funded Health Center
340B ID
CH08103U
Entity Address
118 NORTH MAIN
ISABEL, SD 57633-0097
Grant Number
H80CS00135
Participating Start Date
7/1/2016
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
FAMILY PHARMACY OF MOBRIDGE
Pharmacy Address
1317 10TH AVE W # 759
INC.
MOBRIDGE, SD 57601-1146
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
5/8/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Melissa Hofer, Chief Financial Officer
(605) 772-4525
Contract Pharmacy Representative
FAMILY PHARMACY OF MOBIDGE
LEVI JENSEN, PHARMACIST
(605) 845-8140
Signed By Date
4/17/2023
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