340B Drug Pricing Program Database

Office of Pharmacy Affairs Logo

MEDICINE MAN NORTH PHARMACY
DSH130049 KOOTENAI HEALTH INC

Covered Entity Details

KOOTENAI HEALTH
Disproportionate Share Hospital
DSH130049
2003 Kootenai Health Way
COEUR DALENE, ID 83814
130049
7/1/2021
8/20/2024
7/1/2025


Pharmacy Details

INC DBA MEDICINE MAN PRAIRIE
8093 N CORNERSTONE DR
HAYDEN, ID 83835-8753

Contract Details

9/16/2014
10/1/2014

4/1/2019
Covered Entity Terminated


Contacts


Jeremy S. Evans, Vice President
(208) 625-4002



Medicine Man Prairie
Barry Feely, Owner
(208) 762-9355
9/16/2014