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WALL'S MEDICINE CENTER INC
CH081151A SPECTRA HEALTH
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Covered Entity Details
Entity Name
SPECTRA HEALTH
Subdivision Name
Spectra Health Larimore
Type
HRSA-Funded Health Center
340B ID
CH081151A
Entity Address
607 Towner Ave
Larimore, ND 58251
Grant Number
H80CS01808
Participating Start Date
4/1/2012
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALL'S MEDICINE CENTER INC
Pharmacy Address
708 S WASHINGTON ST
GRAND FORKS, ND 58201-4328
Pharmacy Comments
Contract Details
Approval Date
4/11/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tiffany Schmidt, CFO
(701) 757-2100 Ext: 2002
Contract Pharmacy Representative
Prairie Pharmacy FA1
Dennis Johnson, Owner
(701) 314-0056
Signed By Date
4/11/2025
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