Contract Pharmacy Details

ALBERTSONS LLC
CHC24102-16 BIGHORN VALLEY HEALTH CENTER INC

Covered Entity Details

Entity Name

BIGHORN VALLEY HEALTH CENTER INC

Subdivision Name

One Health - Panther Clinic

Type

HRSA-Funded Health Center

340B ID

CHC24102-16

Entity Address

410 Triple Crown St RM A108
Belgrade, MT 59714-3402

Grant Number

H80CS24102

Participating Start Date

10/1/2024

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

ALBERTSONS LLC

Pharmacy Address

OSCO PHARMACY #9
6999 JACKRABBIT LANE
BELGRADE, MT 59714

Pharmacy Comments

Contract Details

Approval Date

8/8/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

David A. Mark, Chief Executive Officer
(406) 665-4103

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

8/7/2024

340B Drug Pricing Program Database