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RIVER MEDICAL PHARMACY LLC
CAH131325-00 BMH, INC. DBA BINGHAM MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
BMH, INC. DBA BINGHAM MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH131325-00
Entity Address
98 POPLAR
BLACKFOOT, ID 83221
Medicare Provider Number
131325
Participating Start Date
9/8/2010
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jake Erickson, CEO
(208) 785-3803
Contract Pharmacy Representative
BioPlus
Todd Weber, Director Carelonrx 340b Contract Sales
(888) 292-0744
Signed By Date
4/15/2024
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