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VANS PHARMACY
CH083270 BUTTE-SILVER BOW PRIMARY HEALTH CARE CLINIC, INC
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Covered Entity Details
Entity Name
BUTTE-SILVER BOW PRIMARY HEALTH CARE CLINIC, INC
Subdivision Name
BUTTE-SILVER BOW PRIMARY HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH083270
Entity Address
445 Centennial Ave.
Butte, MT 59701-2870
Grant Number
H80CS00799
Participating Start Date
7/1/1998
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
VANS PHARMACY
Pharmacy Address
ATTN: BONNIE R. REBISH, RPH, PHARMACIST
110 SOUTHSIDE BOULEVARD
DILLON, MT 59725
Pharmacy Comments
Contract Details
Approval Date
7/21/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/3/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Jessica Hoff, CEO
(406) 723-4075 Ext: 275
Contract Pharmacy Representative
Bonnie Rebish, PHARMACIST IN CHARGE
(406) 988-7121
Signed By Date
7/21/2014
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