340B Drug Pricing Program Database

Pharmacy Name

MONUMENT HEALTH RAPID CITY HOSPITAL

Pharmacy Address

PHARMACY DEPARTMENT
353 FAIRMONT BLVD
RAPID CITY, SD 57701

Pharmacy Comments

Approval Date

10/20/2011

Contract Begin Date

10/1/2011

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/17/2017
Ownership change

Covered Entity Signing Official

Sherry Bea Smith, CEO-Lead-Deadwood Regional Hospital
(605) 719-6122

Contract Pharmacy Representative

Timothy Sughrue, CEO
(605) 719-1000

Signed By Date

8/15/2011