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HUGOS FAMILY PHARMACY
CAH241320-00 RiverView Healthcare Association
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Covered Entity Details
Entity Name
RiverView Healthcare Association
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241320-00
Entity Address
323 S. Minnesota Street
Crookston, MN 56716
Medicare Provider Number
241320
Participating Start Date
1/1/2014
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
HUGOS FAMILY PHARMACY
Pharmacy Address
215 PENNINGTON AVENUE
THIEF RIVER FALLS, MN 56701-2900
Pharmacy Comments
Contract Details
Approval Date
7/10/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/20/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Betty Arvidson, CFO
(218) 281-9756
Contract Pharmacy Representative
Hugo's Family Pharmacy
SEAN KARPOWICH, DIRECTOR OF PHARMACY
(218) 773-0611
Signed By Date
7/10/2015
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