Contract Pharmacy Details

BREHM DRUG
CAH281338-00 Howard County Medical Center

Covered Entity Details

Entity Name

Howard County Medical Center

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH281338-00

Entity Address

1113 Sherman St
St Paul, NE 68873

Medicare Provider Number

281338

Participating Start Date

1/1/2013

Last Recertification Date

8/15/2024

Pharmacy Details

Pharmacy Name

BREHM DRUG

Pharmacy Address

608 HOWARD AVE
SAINT PAUL, NE 68873

Pharmacy Comments

Contract Details

Approval Date

4/2/2013

Contract Begin Date

7/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/13/2020
Ownership change

Contacts

Covered Entity Signing Official

Arlan D. Johnson, CEO
(308) 754-4421 Ext: 300

Contract Pharmacy Representative

David Brehm, President
(308) 754-4611

Signed By Date

4/2/2013