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O'NEILL FAMILY PHARMACY
CAH281329-00 AVERA ST. ANTHONY'S HOSPITAL
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Covered Entity Details
Entity Name
AVERA ST. ANTHONY'S HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281329-00
Entity Address
300 NORTH 2ND ST
O'NEILL, NE 68763
Medicare Provider Number
281329
Participating Start Date
1/1/2011
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
O'NEILL FAMILY PHARMACY
Pharmacy Address
O'NEILL FAMILY PHARMACY
317 E. DOUGLAS ST.
ONEILL, NE 68763-1829
Pharmacy Comments
Contract Details
Approval Date
10/17/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHAEL L. GARMAN, CFO
(402) 336-5132
Contract Pharmacy Representative
Kevin Barlow, Owner
(402) 336-2660
Signed By Date
10/17/2016
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