Contract Pharmacy Details

SHOPKO PHARMACY #2058
CH00456E RURAL HEALTH CARE, INC.

Covered Entity Details

Entity Name

RURAL HEALTH CARE, INC.

Subdivision Name

Access Health - Fort Pierre

Type

HRSA-Funded Health Center

340B ID

CH00456E

Entity Address

202 Island Dr STE 1
Fort Pierre, SD 57532-7303

Grant Number

H80CS00456

Participating Start Date

7/1/2011

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

SHOPKO PHARMACY #2058

Pharmacy Address

1755 NORTH HUMISTON AVE
WORTHINGTON, MN 56187

Pharmacy Comments

Contract Details

Approval Date

4/18/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/25/2018
Pharmacy closed

Contacts

Covered Entity Signing Official

JAMES M. HARDWICK, CEO
(605) 223-2200

Contract Pharmacy Representative

ShopKo
Lorie Neumann, Contracting & Compliance
(920) 429-4726

Signed By Date

4/18/2016

340B Drug Pricing Program Database