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THRIFTY WHITE PHARMACY #005
CH081071K Northland Health Partners Community Health Center
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Covered Entity Details
Entity Name
Northland Health Partners Community Health Center
Subdivision Name
Bismarck Clinic
Type
HRSA-Funded Health Center
340B ID
CH081071K
Entity Address
914 S 12th St, Ste 101
Bismarck, ND 58504
Grant Number
H80CS00847
Participating Start Date
10/1/2017
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THRIFTY WHITE PHARMACY #005
Pharmacy Address
707 SOUTH 3RD ST
BISMARCK, ND 58504
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
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
1/12/2018
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