340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SAMUELSON'S DRUG STORE
CAH241363-00 STEVENS COMMUNITY MEDICAL CENTER
Print
Covered Entity Details
Entity Name
STEVENS COMMUNITY MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241363-00
Entity Address
400 EAST 1ST ST
MORRIS, MN 56267
Medicare Provider Number
241363
Participating Start Date
9/28/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
SAMUELSON'S DRUG STORE
Pharmacy Address
118 W 5TH ST
STARBUCK, MN 56381-2426
Pharmacy Comments
Contract Details
Approval Date
1/14/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/11/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
KERRIE MCEVILLY, President/CEO
(320) 589-7655
Contract Pharmacy Representative
Samuelson's Drug
Donald Samuelson, Pharmacist & Owner
(320) 239-2246
Signed By Date
1/14/2016
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