340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WHITE DRUG #66
CAH351322-00 ASHLEY MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ASHLEY MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH351322-00
Entity Address
612 CENTER AVENUE NORTH
ASHLEY, ND 58413
Medicare Provider Number
351322
Participating Start Date
10/1/2015
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WHITE DRUG #66
Pharmacy Address
109 W MAIN ST
P.O. BOX 329
ASHLEY, ND 58413-7003
Pharmacy Comments
Contract Details
Approval Date
10/15/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jerry Lepp, CFO
(701) 288-3433 Ext: 264
Contract Pharmacy Representative
Alicia Hager, Pharmacy Operation Specialist
(763) 463-4482
Signed By Date
10/15/2015
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