340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WILLOW CREEK HEALTH MART
CAH061300-00 Kiowa County Hospital District DBA Weisbrod Memorial Hospital
Print
Covered Entity Details
Entity Name
Kiowa County Hospital District DBA Weisbrod Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061300-00
Entity Address
1208 Luther Street
Eads, CO 81036
Medicare Provider Number
061300
Participating Start Date
10/1/2011
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WILLOW CREEK HEALTH MART
Pharmacy Address
1700 S MAIN ST
LAMAR, CO 81052-3827
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charlene Korrell, CEO
(719) 438-5401
Contract Pharmacy Representative
Willow Creek Healthmart
Katie Appel, Main 340B Point of Contact
(719) 336-3200
Signed By Date
4/16/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session