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U-SAVE PHARMACY OF NORFOLK
CHC10590-01 Midtown Health Center, Inc.
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Covered Entity Details
Entity Name
Midtown Health Center, Inc.
Subdivision Name
Midtown Health Center-Madison
Type
HRSA-Funded Health Center
340B ID
CHC10590-01
Entity Address
222 South Main Street
Madison, NE 68748-6485
Grant Number
H80CS10590
Participating Start Date
4/1/2010
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
U-SAVE PHARMACY OF NORFOLK
Pharmacy Address
1001 W BENJAMIN AVE
NORFOLK, NE 68701
Pharmacy Comments
Contract Details
Approval Date
8/16/2010
Contract Begin Date
8/16/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KIM KWAPNIOSKI, EXECUTIVE DIRECTOR
(402) 644-7414
Contract Pharmacy Representative
MARK BOCHE, OWNER
(402) 379-8728
Signed By Date
8/13/2010
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