Contract Pharmacy Details

LEWIS FAMILY DRUG #37
CH080890 UNION COUNTY HEALTH FOUNDATION

Covered Entity Details

Entity Name

UNION COUNTY HEALTH FOUNDATION

Subdivision Name

Community Health Clinic

Type

HRSA-Funded Health Center

340B ID

CH080890

Entity Address

204 E Main St
Elk Point, SD 57025-2334

Grant Number

H80CS00534

Participating Start Date

4/1/1998

Last Recertification Date

1/26/2017

Entity Termination Date

10/1/2017

Pharmacy Details

Pharmacy Name

LEWIS FAMILY DRUG #37

Pharmacy Address

LEWIS FAMILY DRUG, LLC
204 W MAIN ST
ELK POINT, SD 57025-5710

Pharmacy Comments

Contract Details

Approval Date

3/31/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2017

Contacts

Covered Entity Signing Official

Brad Bertrand, CEO
(605) 356-3317

Contract Pharmacy Representative

Lewis Drug
Scott Cross, EVP
(605) 367-2800

Signed By Date

3/31/2016

340B Drug Pricing Program Database