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MILFORD VALU-RITE PHARMACY
CAH281339-00 MEMORIAL HEALTH CARE SYSTEMS DBA MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
MEMORIAL HEALTH CARE SYSTEMS DBA MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281339-00
Entity Address
300 NORTH COLUMBIA AVENUE
SEWARD, NE 68434-2299
Medicare Provider Number
281339
Participating Start Date
7/1/2011
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
MILFORD VALU-RITE PHARMACY
Pharmacy Address
610 1ST ST
PO BOX 706
MILFORD, NE 68405-9611
Pharmacy Comments
Contract Details
Approval Date
10/14/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/7/2021
Ownership change
Contacts
Covered Entity Signing Official
ROGER REAMER, CHIEF EXECUTIVE OFFICER
(402) 646-4629
Contract Pharmacy Representative
Charles Pierce, President
(402) 761-2222
Signed By Date
10/14/2014
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