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BEN'S FAMILY PHARMACY
CAH061306-00 LINCOLN COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
LINCOLN COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061306-00
Entity Address
111 6TH STREET
HUGO, CO 80821
Medicare Provider Number
061306
Participating Start Date
4/1/2018
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
BEN'S FAMILY PHARMACY
Pharmacy Address
DBA HONEST OAK LLC
333 M AVE STE 100
LIMON, CO 80828
Pharmacy Comments
Contract Details
Approval Date
1/16/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin M. Stansbury, CEO
(719) 743-2421
Contract Pharmacy Representative
Honest Oak LLC
Ben Ferree, Owner
(719) 775-0500
Signed By Date
1/12/2018
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