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FRONTIER FAMILY PHARMACY
CAH281327-00 Cozad Community Hospital
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Covered Entity Details
Entity Name
Cozad Community Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH281327-00
Entity Address
300 E 12 Street
Cozad, NE 69130
Medicare Provider Number
281327
Participating Start Date
1/1/2014
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
FRONTIER FAMILY PHARMACY
Pharmacy Address
312 W 8TH ST
COZAD, NE 69130
Pharmacy Comments
Contract Details
Approval Date
4/5/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lyle E. Davis, Administrator
(308) 784-2261 Ext: 1203
Contract Pharmacy Representative
Frontier Family Pharmacy
Tyler Sturgeon, Owner
(308) 784-3500
Signed By Date
4/5/2016
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