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NORTHSIDE PHARMACY
CH081030 HORIZON HEALTH CARE, INC
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Covered Entity Details
Entity Name
HORIZON HEALTH CARE, INC
Subdivision Name
HORIZON HEALTH - HOWARD MEDICAL
Type
HRSA-Funded Health Center
340B ID
CH081030
Entity Address
208 SOUTH MAIN STREET
HOWARD, SD 57349-0099
Grant Number
H80CS00135
Participating Start Date
12/1/1992
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
NORTHSIDE PHARMACY
Pharmacy Address
100 DAKOTA AVE N STE A
HURON, SD 57350-1630
Pharmacy Comments
Contract Details
Approval Date
1/15/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
WADE ERICKSON, CFO
(605) 772-4525
Contract Pharmacy Representative
Shane Clarambeau, Owner
(605) 352-9222
Signed By Date
1/15/2014
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