340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ESSENTIA HEALTH SUPERIOR PHARMACY
CAH241357-00 FIRST CARE MEDICAL SERVICES
Print
Covered Entity Details
Entity Name
FIRST CARE MEDICAL SERVICES
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241357-00
Entity Address
900 HILLIGOSS BLVD SE
FOSSTON, MN 56542
Medicare Provider Number
241357
Participating Start Date
4/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
ESSENTIA HEALTH SUPERIOR PHARMACY
Pharmacy Address
3500 TOWER AVE STE A
SUPERIOR, WI 54880
Pharmacy Comments
Contract Details
Approval Date
10/13/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/7/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kimberly Bodensteiner, CFO
(218) 435-7633
Contract Pharmacy Representative
Essentia Health
Tim Cernohous, Director of Ambulatory Pharmacy
(218) 786-8516
Signed By Date
10/13/2016
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