Contract Pharmacy Details

SEIP PRESCRIPTION SHOPPE
CAH241354-00 Astera Health

Covered Entity Details

Entity Name

Astera Health

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH241354-00

Entity Address

421 11th Street NW
Wadena, MN 56482

Medicare Provider Number

241354

Participating Start Date

1/1/2012

Last Recertification Date

8/16/2024

Pharmacy Details

Pharmacy Name

SEIP PRESCRIPTION SHOPPE

Pharmacy Address

415 JEFFERSON ST N
WADENA, MN 56482-5656

Pharmacy Comments

Contract Details

Approval Date

7/8/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/22/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

Joel Beiswenger, CEO
(218) 631-7489

Contract Pharmacy Representative

Seip Drug
Nate Seip, CEO
(218) 385-3360

Signed By Date

7/8/2015