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LARIMORE DRUG AND GIFT INC
CH0811510 SPECTRA HEALTH
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Covered Entity Details
Entity Name
SPECTRA HEALTH
Subdivision Name
Spectra Health Admin Office
Type
HRSA-Funded Health Center
340B ID
CH0811510
Entity Address
212 South 4th Street, Suite 200
Grand Forks, ND 58201-0160
Grant Number
H80CS01808
Participating Start Date
7/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LARIMORE DRUG AND GIFT INC
Pharmacy Address
203 TOWNER AVENUE
BOX 438
LARIMORE, ND 58251
Pharmacy Comments
Contract Details
Approval Date
4/1/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/31/2020
Ownership change
Contacts
Covered Entity Signing Official
Sharon Ericson, CEO
(701) 587-6000
Contract Pharmacy Representative
Dorothy Farrell, Pharmacist
(701) 343-2461
Signed By Date
4/1/2013
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