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WELLS DRUG
CAH281334-00 BOONE COUNTY HEALTH CENTER
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Covered Entity Details
Entity Name
BOONE COUNTY HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281334-00
Entity Address
723 WEST FAIRVIEW STREET
ALBION, NE 68620
Medicare Provider Number
281334
Participating Start Date
7/1/2011
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
WELLS DRUG
Pharmacy Address
113 S 4TH ST
ALBION, NE 68620-1215
Pharmacy Comments
Contract Details
Approval Date
7/6/2017
Contract Begin Date
7/7/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tanya Sharp, PRESIDENT AND CEO
(402) 395-3213
Contract Pharmacy Representative
James Wells, Owner
(402) 395-2184
Signed By Date
7/6/2017
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