340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
NORTHTOWN DRUG
FQHCLA257 MARIAS HEALTHCARE SERVICES, INC.
Print
Covered Entity Details
Entity Name
MARIAS HEALTHCARE SERVICES, INC.
Subdivision Name
Type
Health Center Program Look-Alike
340B ID
FQHCLA257
Entity Address
670 PARK AVE
SHELBY, MT 59474
Grant Number
LALCS00043
Participating Start Date
7/1/2010
Last Recertification Date
1/28/2015
Entity Termination Date
1/1/2016
Pharmacy Details
Pharmacy Name
NORTHTOWN DRUG
Pharmacy Address
ANN CLARK
100 MAIN ST
PO BOX 917
SHELBY, MT 59474-1906
Pharmacy Comments
Contract Details
Approval Date
8/17/2012
Contract Begin Date
8/17/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2016
Contacts
Covered Entity Signing Official
Jamie F Brownell, CEO
(406) 434-3110
Contract Pharmacy Representative
Northtown
Ann Clark, Pharmacist
(406) 434-5115
Signed By Date
8/1/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session