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CHASE PHARMACY INC
CAH351303-00 Garrison Memorial Hospital
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Covered Entity Details
Entity Name
Garrison Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH351303-00
Entity Address
407 3rd Ave SE
Garrison, ND 58540
Medicare Provider Number
351303
Participating Start Date
10/1/2012
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
CHASE PHARMACY INC
Pharmacy Address
21 N MAIN ST
GARRISON, ND 58540-0189
Pharmacy Comments
Contract Details
Approval Date
1/5/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tod Graeber, Administrator
(701) 463-2275 Ext: 505
Contract Pharmacy Representative
Retail Pharmacy
Kim Essler, RPH
(701) 463-2242
Signed By Date
1/5/2018
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