340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SHOPKO PHARMACY #2759
CAH431321-00 MONUMENT HEALTH STURGIS HOSPITAL
Print
Covered Entity Details
Entity Name
MONUMENT HEALTH STURGIS HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH431321-00
Entity Address
2140 Junction Ave.
STURGIS, SD 57785
Medicare Provider Number
431321
Participating Start Date
4/1/2011
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
SHOPKO PHARMACY #2759
Pharmacy Address
2105 LAZELLE ST
SUITE 2
STURGIS, SD 57785
Pharmacy Comments
Contract Details
Approval Date
4/11/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/4/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Mark Schulte, President
(605) 720-2411
Contract Pharmacy Representative
Shopko
Tad Schilke, Director of Rx Merchandising & Marketing
(920) 429-7628
Signed By Date
4/11/2014
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