340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
NEVADA CVS PHARMACY, L.L.C.
SCH130002-00 St. Luke's Magic Valley Regional Medical Center, LTD
Print
Covered Entity Details
Entity Name
St. Luke's Magic Valley Regional Medical Center, LTD
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH130002-00
Entity Address
801 Pole Line Rd.West
Twin Falls, ID 83301
Medicare Provider Number
130002
Participating Start Date
7/1/2013
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
NEVADA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08801
550 W. IDAHO ST
ELKO, NV 89801
Pharmacy Comments
Contract Details
Approval Date
10/3/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kate Fowler, Senior VP & CFO
(208) 381-8717
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/3/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session