340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
TOM'S FAMILY PHARMACY
CAH161331-00 Mercy Medical Center New Hampton
Print
Covered Entity Details
Entity Name
Mercy Medical Center New Hampton
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161331-00
Entity Address
308 NORTH MAPLE AVENUE
NEW HAMPTON, IA 50659
Medicare Provider Number
161331
Participating Start Date
4/1/2011
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
TOM'S FAMILY PHARMACY
Pharmacy Address
GARDNER DRUG, INC
15 E. MAIN, PO BOX 309
NEW HAMPTON, IA 50659
Pharmacy Comments
Contract Details
Approval Date
4/14/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/21/2015
Pharmacy closed
Contacts
Covered Entity Signing Official
JENNIFER RAPENSKE, REGIONAL CFO
(641) 394-1682
Contract Pharmacy Representative
Tom Deutsch, President
(641) 394-4131
Signed By Date
4/14/2014
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