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FOSSTON PHARMACY AND GIFTS
CAH241357-00 FIRST CARE MEDICAL SERVICES
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Covered Entity Details
Entity Name
FIRST CARE MEDICAL SERVICES
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241357-00
Entity Address
900 HILLIGOSS BLVD SE
FOSSTON, MN 56542
Medicare Provider Number
241357
Participating Start Date
4/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
FOSSTON PHARMACY AND GIFTS
Pharmacy Address
DBA NORD'S PHARMACY AND GIFTS
115 JOHNSON AVE N
FOSSTON, MN 56542
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Bodensteiner, CFO
(218) 435-7633
Contract Pharmacy Representative
FOSSTON PHARMACY AND GIFTS
Evan Fonder, Pharmacy Owner
(218) 435-6646
Signed By Date
7/17/2023
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