340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
COBORN'S PHARMACY #32
DSH240036 ST. CLOUD HOSPITAL
Print
Covered Entity Details
Entity Name
ST. CLOUD HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH240036
Entity Address
1406 6TH AVENUE NORTH
Saint Cloud, MN 56303
Medicare Provider Number
240036
Participating Start Date
7/1/2016
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
COBORN'S PHARMACY #32
Pharmacy Address
COBORN'S PHARMACY #2032
1725 PINE CONE RD S
SARTELL, MN 56377
Pharmacy Comments
Contract Details
Approval Date
5/13/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/9/2016
Agreement registered in error
Contacts
Covered Entity Signing Official
Greg Klugherz, CFO
(320) 255-5655
Contract Pharmacy Representative
Coborn's
Jim Cox, 340B Program Director
(320) 257-5505
Signed By Date
5/13/2016
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