340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ESSENTIA HEALTH PRESCRIPTION SERVICE CEN
CAH241309-00 PINE MEDICAL CENTER
Print
Covered Entity Details
Entity Name
PINE MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241309-00
Entity Address
705 LUNDORFF DR
SANDSTONE, MN 55072
Medicare Provider Number
241309
Participating Start Date
7/1/2011
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
ESSENTIA HEALTH PRESCRIPTION SERVICE CEN
Pharmacy Address
204 BELKNAP ST STE 300
SUPERIOR, WI 54880-2905
Pharmacy Comments
Contract Details
Approval Date
10/13/2015
Contract Begin Date
1/1/2016
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
Scott Nigon, CFO
(218) 786-3212
Contract Pharmacy Representative
Essentia Health
Tim Cernohous, Director of Ambulatory Pharmacy
(218) 786-8516
Signed By Date
10/13/2015
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