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ALBERTSONS LLC
CAH271317-00 Livingston Healthcare
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Covered Entity Details
Entity Name
Livingston Healthcare
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH271317-00
Entity Address
320 Alpenglow Lane
Livingston, MT 59047
Medicare Provider Number
271317
Participating Start Date
1/1/2012
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ALBERTSONS LLC
Pharmacy Address
OSCO PHARMACY #42
2120 PARK STREET SOUTH
LIVINGSTON, MT 59047
Pharmacy Comments
Contract Details
Approval Date
7/6/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bren Lowe, CEO
(406) 823-3541 Ext: 6411
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
7/6/2016
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