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THRIFTY WHITE PHARMACY #017
CH081071H Northland Health Partners Community Health Center
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Covered Entity Details
Entity Name
Northland Health Partners Community Health Center
Subdivision Name
Ray Clinic
Type
HRSA-Funded Health Center
340B ID
CH081071H
Entity Address
24 Railroad Ave
Ray, ND 58849
Grant Number
H80CS00847
Participating Start Date
7/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THRIFTY WHITE PHARMACY #017
Pharmacy Address
1015 S BROADWAY STE 3
MINOT, ND 58701-4667
Pharmacy Comments
Contract Details
Approval Date
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patrick Butler, CEO
(701) 448-2054
Contract Pharmacy Representative
Thrifty White
Timothy Weippert, EVP of Pharmacy
(763) 513-4365
Signed By Date
7/18/2017
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