340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
THRIFTY WHITE DRUG #755
CAH241314-00 Dawson Area Hospital District, d/b/a Johnson Memorial Health Services
Print
Covered Entity Details
Entity Name
Dawson Area Hospital District, d/b/a Johnson Memorial Health Services
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241314-00
Entity Address
1282 Walnut Street
Dawson, MN 56232
Medicare Provider Number
241314
Participating Start Date
7/1/2013
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
THRIFTY WHITE DRUG #755
Pharmacy Address
205 6TH AVE
MADISON, MN 56256-1308
Pharmacy Comments
Contract Details
Approval Date
1/15/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Crystal M. Bothun, Chief Financial Officer
(320) 312-2104
Contract Pharmacy Representative
THRIFTY WHITE
Alicia Hager, Pharmacy Operations Specialist
(763) 463-4482
Signed By Date
1/15/2015
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