340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BOOTH PHARMACY INC
CAH161311-00 Hawarden Regional Healthcare
Print
Covered Entity Details
Entity Name
Hawarden Regional Healthcare
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161311-00
Entity Address
1111 11th Street
Hawarden, IA 51023
Medicare Provider Number
161311
Participating Start Date
10/1/2011
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
BOOTH PHARMACY INC
Pharmacy Address
903 CENTRAL AVE
PO BOX 233
HAWARDEN, IA 51023-2233
Pharmacy Comments
Contract Details
Approval Date
7/15/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jayson Pullman, CEO
(712) 551-3103
Contract Pharmacy Representative
Matt Hummel, Owner
(712) 551-2374
Signed By Date
7/15/2014
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