2009 Pharmacy Directory

Transcription

1 This directory is for: IOWA, MINNESOTA, MONTANA, NEBRASKA, NORTH DAKOTA, SOUTH DAKOTA, WYOMING United American Insurance Company 2009 Pharmacy Directory UA Medicare Part D UA Medicare Part D Silver UA Medicare Group Part D This booklet provides a list of network pharmacies. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. To get current information about network pharmacies in your area, or if you need further information, contact Customer Service at the number listed on the back of your Part D member ID card. Introduction To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and your plan Formulary. If you have additional questions, please call Customer Service at the number listed on the back of your Part D member ID card. We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. A network pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits provided by your Medicare Prescription Drug Plan. In most cases, your prescriptions are covered under your Plan only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one, you are not required to continue going to the same pharmacy to fill your prescription. You can go to any of our network pharmacies. We will fill prescriptions at nonnetwork pharmacies under certain circumstances as described in your Evidence of Coverage. S5755_09PHARM F7048_25

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3 IOWA

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5 Retail Pharmacies IOWA

6 BENTON Vinton IOWA Cligman Pharmacy 106 E 4Th St Vinton,IA (319) La Grange Pharmacy 111 W 4Th St Vinton,IA (319) BLACK HAWK Waterloo Falls Road Drug 2027 Falls Ave Waterloo,IA (319) Kimball Ave Drug 2104 Kimball Ave Waterloo,IA (319) Q & T Pharmacy 920 W 5Th St Waterloo,IA (319) BREMER Denver Martin Health Services 130 W Fayette St / PO Box C Denver,IA (319) Waverly Center Pharmacy 312 9Th St SW Ste 1000 Waverly,IA (319) BUTLER Parkersburg Siechs Parkersburg Phcy 235 3Rd St Parkersburg,IA (319) CARROLL Carroll Carroll Apothecary 707 N Main St Carroll,IA (712) Carroll Clinic Nursing Home Phar 405 S Clark St Ste 150A Carroll,IA (712) Carroll Clinic Pharmacy 405 S Clark St Ste 150 Carroll,IA (712) CERRO GORDO Mason City Mercy Long Term Care Phcy 621 S Illinois Ave Ste 104 Mason City,IA (641) CLAYTON Elkader Moser Family Pharmacy 135 North Main Elkader,IA (563) Guttenberg Guttenberg Pharmacy Inc 807 S Highway 52 Guttenberg,IA (563) Monona Monona Pharmacy 118 W Center St Monona,IA (563) CLINTON Clinton Clinton Med Clinic Phcy 221 Main Ave Clinton,IA (563) Mercy Hospital Pharmacy 1410 N 4Th St Clinton,IA (563) Women's Health Services 2635 Lincoln Way Clinton,IA (563) Wrightway Ltc Pharmacy 200 5Th Ave S Clinton,IA (563) De Witt Dewitt Pharmacy Inc 609 7Th Street De Witt,IA (563) Scott Drug Clinic Pharmacy Th St De Witt,IA (563) Scott Drug Company 629 6Th Ave De Witt,IA (563) DALLAS Waukee Medicap Pharmacy # N Warrior Ln Waukee,IA (515) DAVIS Bloomfield US Truecare Pharmacy 101 E Jefferson St Bloomfield,IA (641) DELAWARE Manchester The Medicine Shoppe # W Main St Manchester,IA (563) Widner Drug Store 111 S Franklin St Manchester,IA (563) DES MOINES Burlington Planned Parenthood of 620 N 8Th St Burlington,IA (319) West Burlington Heritage Partners Pharmacy 1223 S Gear Ave West Burlington,IA (319) DUBUQUE Dubuque Mercy Caremor 535 Hill St Dubuque,IA (563) IA Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 73 IOWA

7 IA FAYETTE Stuart IOWA KEOKUK Fayette Scott Pharmacy 238 S Main St Fayette,IA (563) Oelwein Wright Pharmacy 303 SW 7Th St Stuart,IA (515) HANCOCK Britt Williamsburg Peterson Drug Co 514 Elm St Williamsburg,IA (319) JASPER North English Noel Pharmacy 132 South Main Street North English,IA (319) KOSSUTH Retail Pharmacies Schuchmanns Pharmacy Inc 12 S Frederick Ave Oelwein,IA (319) West Union Steege Pharmacy 119 N Vine St West Union,IA (563) FLOYD Charles City Charles City Long Term Care Phcy 1501 S Main St Ste 2 Charles City,IA (641) GRUNDY Conrad Nu Cara Pharmacy # Center St Conrad,IA (641) Grundy Center Manly Drug Store 621 G Ave Grundy Center,IA (319) GUTHRIE Guthrie Center Dowd Drug Inc 307 State St Guthrie Center,IA (641) Fedders Healthmart 52 Main Ave N Britt,IA (641) HARDIN Iowa Falls Rieber's Prescription Phy 520 Talbott St Ste 2 Iowa Falls,IA (641) HARRISON Logan Eby Drug Store Logan Inc 103 N 4Th Ave Logan,IA (712) HOWARD Cresco Hoines Drug Store 113 N Elm St Cresco,IA (563) Lime Springs Lime Springs Pharmacy 101 W Main St Lime Springs,IA (563) IDA Holstein Main Street Pharmacy 103 N Main St Holstein,IA (712) Newton Medicap Pharmacy 400 1St Ave W Newton,IA (641) The Medicine Shoppe 212 1St St N Newton,IA (641) JOHNSON Coralville Nu Cara Pharmacy # Th St Coralville,IA (319) Valuscript Pharmacy 4105 Westcor Ct Ste 1 Coralville,IA (000) Iowa City Uihc Ambulatory Care Phcy 200 Hawkins Dr Iowa City,IA (319) North Liberty Pharmacy Matters # Lininger Lane Ste 238 North Liberty,IA (319) Wellman Remedy Drug Inc 221 8Th Ave Wellman,IA (319) Algona Krhc Family Pharmacy 1519 S Phillips St Algona,IA (515) LEE Fort Madison Rashid Pharmacy P L C 2404 Avenue L Fort Madison,IA (319) LINN Cedar Rapids 1030 Medical Pharmacy Th Ave SE Cedar Rapids,IA (319) Cr IV Service Inc Th St SE Ste 100 Cedar Rapids,IA (319) Iowa Blood And Cancer 855 A Ave NE Cedar Rapids,IA (319) Iowa Pharmaceutical Services Th St SE Cedar Rapids,IA (319) Medicap Pharmacy # Th St SW Cedar Rapids,IA (319) This pharmacy does not offer extended supplies of maintenance medications. IOWA

8 NW Medical Clinic Phcy 75 Short St NW Cedar Rapids,IA (319) LYON Rock Rapids Corner Rexall Drugs 220 1St Ave Rock Rapids,IA (712) MARSHALL Marshalltown Medicap Pharmacy # N 3Rd Ave Marshalltown,IA (641) MILLS Glenwood Medicap Pharmacy # S Locust St Glenwood,IA (712) MITCHELL Osage Jakobson Drug 635 Main St Osage,IA (641) Saint Ansgar Brower Drug Co 140 W 4Th St Saint Ansgar,IA (641) MONONA Onawa Stangel Pharmacy Inc 821 Iowa Ave Onawa,IA (712) Stangel Pharmacy Ltc 821 Iowa Ave Onawa,IA (712) Whiting Whiting Family Pharmacy 723 Whittier St Whiting,IA (712) MONTGOMERY Red Oak Medicap Pharmacy 600 Senate Ave Red Oak,IA (712) MUSCATINE Muscatine Wester Drug 315 E 2Nd St Muscatine,IA (563) O'BRIEN Hartley Med Equip Pharmacy #0 141 S Central Ave Hartley,IA (712) Paullina Barama Drug 127 N Main St Paullina,IA (712) OSCEOLA Sibley Park Pharmacy 804 6Th St Sibley,IA (712) PALO ALTO Emmetsburg Hughes Pharmacy 2216 Main St Emmetsburg,IA (712) POLK Altoona Lutz Long Term Care Pharmacy 120 8Th St SE Ste B Altoona,IA (515) Medicap Pharmacy # Th St Altoona,IA (515) Ankeny Medicap Pharmacy # NE Delaware Ave Ankeny,IA (515) Mercy North Pharmacy 800 E 1St St Ste 1800 Ankeny,IA (515) Merwin Ltc Pharmacy 1555 SE Delaware Ave Ste R Ankeny,IA (515) Des Moines Medicap Pharmacy 3825 SW 9Th St Des Moines,IA (515) Medicap Pharmacy # Easton Blvd Des Moines,IA (515) Medicap Pharmacy E 14Th St Des Moines,IA (515) Mercy Out Patient Pharmacy Th Ave Des Moines,IA (515) Mercy Specialty Care Phcy Th St Ste 4 Des Moines,IA (515) Ward East Side Pharmacy 2501 E Walnut St Des Moines,IA (515) Grimes Medicap Pharmacy # Gateway Dr Grimes,IA (515) Johnston Sun Pharmacy 6105 Merle Hay Rd Johnston,IA (515) Urbandale Economed of Ia Aurora Ave Urbandale,IA (000) Iowa Care Systems Aurora Ave Urbandale,IA (515) Kindred Pharmacy Services Th St Urbandale,IA (515) Nucara Pharmacy # NW Urbandale Dr Urbandale,IA (515) IA Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 75 IOWA

9 IA SCOTT Bettendorf Main At Locust Phcy Inc 2151 Kimberly Rd Bettendorf,IA (563) STORY Ames Iowa State University Rm 1042 Student Hlthcntr Ames,IA (515) WARREN Indianola Medicap Pharmacy 208 E Euclio Ave Indianola,IA (515) Friendship Haven Phcy S Kenyon Road Fort Dodge,IA (515) WINNESHIEK Decorah Main Healthcare Services 2151 Kimberly Rd Bettendorf,IA (563) Davenport Medicap Pharmacy # Lincoln Way Ames,IA (515) Nevada Medicap Pharmacy # E Euclid Ave Indianola,IA (515) WASHINGTON Donlon Snyder Drug 201 W Water St Decorah,IA (563) WOODBURY Retail Pharmacies Community Hlth Care Inc 500 W River Dr Davenport,IA (563) First Med Pharmacy 1227 E Rusholme St Davenport,IA (563) Hematology Medical Oncology Cons 1351 W Central Park Ave Davenport,IA (563) The Medicine Shoppe # Brady St Davenport,IA (563) Eldridge North Scott Pharmacy 225 E Le Claire Rd Eldridge,IA (563) Le Claire Schwenke Pharmacy 126 S Cody Rd Le Claire,IA (563) Parkview Pharmacy 1727 S B Ave Nevada,IA (515) Story City Advocare Pharmacy #2 621 Broad St Ste 100 Story City,IA (515) UNION Creston Crest Pharmacy Inc 1610 W Townline St Ste 105 Creston,IA (641) WAPELLO Ottumwa South Side Drug 337 Church St Ottumwa,IA (641) West End Drug Inc 105 W Main St Ste 102 Ottumwa,IA (641) Washington Beans Pharmacy 222 S Iowa Ave Washington,IA (319) WAYNE Bellevue Bellvue Pharmacy 115 State St Bellevue,IA (563) Corydon Nessen Pharmacy 104 S Franklin St Corydon,IA (641) WEBSTER Dayton Family Pharmacy 21 S Main Street Dayton,IA (515) Fort Dodge Community Health Center of Ft Do 126 N 10Th St Fort Dodge,IA (515) Anthon Mills Pharmacy 120 E Main Anthon,IA (712) Moville Moville Pharmacy 216 E Main St Moville,IA (712) Sergeant Bluff Sergeant Bluff Pharmacy 110 Gaul Dr Ste A Sergeant Bluff,IA (712) Sioux City Drilling Health Mart 4010 Morningside Ave Sioux City,IA (712) Siouxland Community Hlth 1021 Nebraska St Sioux City,IA (712) Valumed Pharmacy 224 4Th St Ste 100 Sioux City,IA (712) This pharmacy does not offer extended supplies of maintenance medications. IOWA

10 WORTH Northwood Verhelst Drug Center 98 10Th St N Northwood,IA (641) WRIGHT Clarion Clarion Pharmacy 210 N Main St Clarion,IA (515) IA Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications IOWA

11 Chain Pharmacies IOWA 11

12 ADAIR IOWA Greenfield Pamida Pharmacy # SW Kent St Greenfield,IA (641) ALLAMAKEE Waukon Pamida Pharmacy # Th Ave SW Waukon,IA (563) APPANOOSE Centerville Hy-Vee Pharmacy # N 18Th St Centerville,IA (641) Medicap Pharmacy # N 18Th St Centerville,IA (641) Wal*Mart # N 18Th St Centerville,IA (641) AUDUBON Audubon Medicap Pharmacy # Broadway St Audubon,IA (712) Pamida Pharmacy # N Market St Audubon,IA (712) BLACK HAWK Cedar Falls CVS Pharmacy # W 1St St Cedar Falls,IA (319) Hy-Vee Pharmacy # University Ave Cedar Falls,IA (319) Medicap Pharmacy # Waterloo Rd Cedar Falls,IA (319) Wal*Mart Phcy # Brandilynn Blvd Cedar Falls,IA (319) Walgreens # White Tail Dr Cedar Falls,IA (319) Waterloo CVS Pharmacy # Crossroads Blvd Waterloo,IA (319) CVS Pharmacy # Logan Ave Waterloo,IA (319) Hy-Vee Pharmacy #2 (1863) 2181 Logan Ave Waterloo,IA (319) Hy-Vee Pharmacy #3 (1866) 1422 Flammang Dr Waterloo,IA (319) Hy-Vee Pharmacy #4 (1869) 4000 University Ave Waterloo,IA (319) K Mart # University Ave Waterloo,IA (319) Target #T E San Marnan Dr Waterloo,IA (319) Wal*Mart # Flammang Dr Waterloo,IA (319) Walgreens # University Ave Waterloo,IA (319) Walgreens # W Ridgeway Ave Waterloo,IA (319) BOONE Boone Hy-Vee Pharmacy # Th St Boone,IA (515) Medicap Pharmacy # Story St Boone,IA (515) Wal*Mart # S Story St Boone,IA (515) Walgreens # Story St Boone,IA (515) Madrid Medicap Pharmacy # Annex Rd Madrid,IA (515) BREMER Waverly Hy-Vee Pharmacy # Th St SW Waverly,IA (319) Wal*Mart # Th St SW Waverly,IA (319) BUCHANAN Independence Wal*Mart # Th Ave SW Independence,IA (319) BUENA VISTA Storm Lake Hy-Vee Bedels Phcy # W 5Th St Storm Lake,IA (712) Hy-Vee Clinic Pharmacy # Lake Ave Storm Lake,IA (712) Hy-Vee Pharmacy # N Lake Ave Storm Lake,IA (712) Medicap Pharmacy # Lake Ave Storm Lake,IA (712) Wal*Mart # Lake Ave Storm Lake,IA (712) IA Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 12 IOWA 599

13 IA Chain Pharmacies Walgreens # Lake Ave Storm Lake,IA (712) CALHOUN Manson Medicap Pharmacy # Th Ave Manson,IA (712) CARROLL Carroll Hy-Vee Pharmacy # US Highway 30 W Carroll,IA (712) K Mart # US Highway 30 W Carroll,IA (712) Medicap Pharmacy # E 6Th St Carroll,IA (712) Wal*Mart # US Highway 30 W Carroll,IA (712) Walgreens # E 6Th St Carroll,IA (712) CASS Atlantic Hy-Vee Pharmacy # E 7Th St Atlantic,IA (712) Pamida Pharmacy # Sunnyside Ln Atlantic,IA (712) Wal*Mart Pharmacy # E 7Th St Atlantic,IA (712) CEDAR Lowden Lowden Family Med Clinic 305 McKinley Ave Lowden,IA (563) Tipton Wal*Mart # Highway 38 Tipton,IA (563) CERRO GORDO Clear Lake Econofoods Pharmacy # S 4Th St Clear Lake,IA (641) Thrifty White Drug #64 2 N 4Th St Clear Lake,IA (641) Mason City Drug Town # S Illinois Ave Mason City,IA (641) Hy-Vee Pharmacy #1 (1410) Th St SW Mason City,IA (641) K Mart # Th St SW Mason City,IA (641) Shopko Pharmacy # S Monroe Ave Mason City,IA (641) Target #T Th St SW Mason City,IA (641) Wal*Mart # Th St SW Mason City,IA (641) Walgreens # Th St SW Mason City,IA (641) CHEROKEE Cherokee Drug Town # E Main St Cherokee,IA (712) Hy-Vee Pharmacy # N 2Nd St Cherokee,IA (712) Marcus Drug Town Clinic (7028-1) 321 Main Marcus,IA (712) CHICKASAW New Hampton Pamida Pharmacy # W Milwaukee St New Hampton,IA (641) CLARKE Osceola Medicap Pharmacy # S Main St Osceola,IA (641) Pamida Pharmacy # Jeffreys Dr Osceola,IA (641) Wal*Mart Phcy # College Dr Osceola,IA (641) CLAY Spencer Hy-Vee Pharmacy # Th Ave SW Spencer,IA (712) Wal*Mart Phcy # Th St SW Spencer,IA (712) Walgreens # Grand Ave Spencer,IA (712) White Drug # S Grand Ave Spencer,IA (712) CLINTON Clinton Hy-Vee Pharmacy # S 4Th St Clinton,IA (563) Osco Pharmacy # N 2Nd St Clinton,IA (563) Wal*Mart Phcy # S 25Th St Clinton,IA (563) This pharmacy does not offer extended supplies of maintenance medications. IOWA 13

14 Walgreens # S 4Th St Clinton,IA (563) Walgreens # N 2Nd St Clinton,IA (563) CRAWFORD Denison Hy-Vee Pharmacy # Broadway Denison,IA (712) Thrifty White Drug # Broadway Denison,IA (712) Wal*Mart # Arrowhead Dr Denison,IA (712) DALLAS Dallas Center Medicap Pharmacy # Th St Dallas Center,IA (515) Des Moines Wal*Mart Phcy # Stagecoach Dr Des Moines,IA (515) Perry Hy-Vee Pharmacy # Th St Perry,IA (515) Medicap Pharmacy # S 1St St Perry,IA (515) Pamida Pharmacy # St St Perry,IA (515) West Des Moines Hy-Vee Pharmacy #3 (1889) Th St West Des Moines,IA (515) DAVIS Bloomfield Hy-Vee Pharmacy Clinic # W Jefferson St Bloomfield,IA (641) DELAWARE Manchester Wal*Mart # W Main St Manchester,IA (563) DES MOINES Burlington Hy-Vee Pharmacy #1 (1042) 939 Angular St Burlington,IA (319) Hy-Vee Pharmacy #2 (1044) 3150 Agency St Burlington,IA (319) K Mart # Agency St Burlington,IA (319) Shopko Pharmacy # N Roosevelt Ave Burlington,IA (319) Wal*Mart # Agency St Burlington,IA (319) Walgreens # S 9Th St Burlington,IA (319) Walgreens # Agency St Burlington,IA (319) DICKINSON Milford Hy-Vee Pharmacy # Okoboji Ave Milford,IA (712) Spirit Lake Hy-Vee Pharmacy # Th St Spirit Lake,IA (712) Lewis Family Drug # Th St Spirit Lake,IA (712) Wal*Mart # Highway 71 Spirit Lake,IA (712) DUBUQUE Dubuque Econofoods Pharmacy # Jfk Rd Dubuque,IA (563) Hartig Nursing Home Svcs 2216 Woodland Dr Dubuque,IA (563) Hy-Vee Pharmacy #1 (1159) 3500 Dodge St Dubuque,IA (563) Hy-Vee Pharmacy #2 (1160) 4800 Asbury Rd Dubuque,IA (563) Hy-Vee Pharmacy #3 (1162) 400 S Locust St Dubuque,IA (563) K Mart # Dodge St Dubuque,IA (563) Shopko Pharmacy # John F Kennedy Rd Dubuque,IA (563) Target #T Dodge St Dubuque,IA (563) Wal*Mart # Dodge St Dubuque,IA (563) Wal*Mart Phcy # Asbury Rd Dubuque,IA (563) Walgreens # John F Kennedy Rd Dubuque,IA (563) Walgreens # John F Kennedy Rd Dubuque,IA (563) IA Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications IOWA

15 IA Chain Pharmacies EMMET Estherville Hy-Vee Pharmacy # Central Ave Estherville,IA (712) FAYETTE Oelwein Medicap Pharmacy # S Frederick Ave Oelwein,IA (319) FLOYD Charles City Drug Town # Cedar Mall Charles City,IA (641) K Mart # S Grand Ave Charles City,IA (641) GREENE Jefferson Drug Town # N Wilson St Jefferson,IA (515) Medicap Pharmacy # N Elm St Jefferson,IA (515) GUTHRIE Panora Medicap Pharmacy # E Main St Panora,IA (641) HAMILTON Webster City Hy-Vee Pharmacy # Nd St Webster City,IA (515) Thrifty White Drug # Willson Ave Webster City,IA (515) HARDIN Eldora Medicap Pharmacy # Edgington Ave Eldora,IA (641) Iowa Falls Hy-Vee Pharmacy # S Oak River Hills Iowa Falls,IA (641) Medicap Pharmacy # S Oak St Iowa Falls,IA (641) Wal*Mart # S Oak St Iowa Falls,IA (641) HARRISON Missouri Valley Pamida Pharmacy # W Huron St Missouri Valley,IA (712) HENRY Mount Pleasant Hy-Vee Pharmacy # E Washington St Mount Pleasant,IA (319) Hy-Vee Pharmacy # S White St Mount Pleasant,IA (319) Wal*Mart # US 218 & Maple Leaf Dr Mount Pleasant,IA (319) Mt Pleasant Drug Town # S Jefferson St Mt Pleasant,IA (319) Medicap Pharmacy # W Washington St Mt Pleasant,IA (319) HOWARD Cresco Medicap Pharmacy # Nd Ave SW Cresco,IA (563) HUMBOLDT Humboldt Hy-Vee Pharmacy # Th Ave N Humboldt,IA (515) IDA Ida Grove Lewis Family Drug # Oak Grove Dr Ida Grove,IA (712) JACKSON Maquoketa Wal*Mart # Highway 64 W Maquoketa,IA (563) JASPER Newton Drug Town # St Ave E Newton,IA (641) Hy-Vee Pharmacy # St Ave E Newton,IA (641) Wal*Mart # E 31St St S Newton,IA (641) Walgreens # St Ave E Newton,IA (641) JEFFERSON Fairfield Drug Town # W Burlington Ave Fairfield,IA (641) Hy-Vee Drugstore Clinic # N Main St Fairfield,IA (641) Wal*Mart # W Burlington Ave Fairfield,IA (641) JOHNSON Coralville Hy-Vee Pharmacy # Th St Coralville,IA (319) This pharmacy does not offer extended supplies of maintenance medications. IOWA 15

16 Wal*Mart Phcy # Commerce Dr Coralville,IA (319) Walgreens # Nd St Coralville,IA (319) Walgreens # Heartland Dr Coralville,IA (319) Iowa City Accredo Therapeutics Inc 2415 Heinz Rd Iowa City,IA (319) CVS Pharmacy # S Clinton St Iowa City,IA (319) CVS Pharmacy # Muscatine Ave Iowa City,IA (319) Drug Town # N 1St Ave Iowa City,IA (319) Hy-Vee Pharmacy #1 (1281) 1720 Waterfront Dr Iowa City,IA (319) Hy-Vee Pharmacy #2 (1285) 812 S 1St Ave Iowa City,IA (319) Hy-Vee Pharmacy #3 (1288) 1201 N Dodge St Iowa City,IA (319) K Mart # Hollywood Blvd Iowa City,IA (319) Wal*Mart # Highway 1 W Iowa City,IA (319) Walgreens # Muscatine Ave Iowa City,IA (319) Lone Tree Lone Tree Fmly Practice C 109 W Jayne St Lone Tree,IA (319) JONES Anamosa Wal*Mart # Chamber Dr Anamosa,IA (319) KOSSUTH Algona Hy-Vee Pharmacy # US Highway 169 N Algona,IA (515) K Mart # US Highway 169 N Algona,IA (515) LEE Fort Madison Hy-Vee Pharmacy # Avenue L Fort Madison,IA (319) Shopko Pharmacy # Avenue O Fort Madison,IA (319) Keokuk Hy-Vee Pharmacy # Main St Keokuk,IA (319) Wal*Mart # Main St Keokuk,IA (319) Walgreens # Main St Keokuk,IA (319) LINN Cedar Rapids CVS Pharmacy # Center Point Rd NE Cedar Rapids,IA (319) CVS Pharmacy # Mount Vernon Rd SE Cedar Rapids,IA (319) Drug Town # Boyson Rd NE Cedar Rapids,IA (319) Drug Town # Wilson Ave SW Cedar Rapids,IA (319) Drug Town # Nd St NE Cedar Rapids,IA (319) Drug Town # Mount Vernon Rd SE Cedar Rapids,IA (319) Drug Town # Johnson Ave NW Cedar Rapids,IA (319) Drug Town # Blairs Ferry Rd NE Cedar Rapids,IA (319) Hy-Vee Pharmacy #1 (1054) 1843 Johnson Ave NW Cedar Rapids,IA (319) Hy-Vee Pharmacy #2 (1055) 279 Collins Rd NE Cedar Rapids,IA (319) Hy-Vee Pharmacy #3 (1056) 20 Wilson Ave SW Cedar Rapids,IA (319) Hy-Vee Pharmacy #4 (1060) St Ave NE Cedar Rapids,IA (319) Hy-Vee Pharmacy #6 (1063) 4035 Mount Vernon Rd SE Cedar Rapids,IA (319) Hy-Vee Pharmacy #7 (1064) 5050 Edgewood Rd NE Cedar Rapids,IA (319) K Mart # Collins Rd NE Cedar Rapids,IA (319) K Mart # Th Ave SW Cedar Rapids,IA (319) Medicap Pharmacy # St Ave SE Cedar Rapids,IA (319) Pharmacy Care Associates Th Ave SW Cedar Rapids,IA (319) IA Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications IOWA

17 IA Chain Pharmacies Sam's Pharmacy # Blairs Ferry Rd NE Cedar Rapids,IA (319) Target #T Blairs Ferry Rd NE Cedar Rapids,IA (319) Target #T Edgewood Rd SW Cedar Rapids,IA (319) Wal*Mart # Blairs Ferry Rd NE Cedar Rapids,IA (319) Wal*Mart Phcy # Th Ave SW Cedar Rapids,IA (319) Walgreens # St Ave SE Cedar Rapids,IA (319) Walgreens # Th Ave SW Cedar Rapids,IA (319) Marion Drug Town # Th Ave Marion,IA (319) Hy-Vee Pharmacy # Business Hwy 151 Marion,IA (319) Wal*Mart Phcy # Business Hwy 51 Marion,IA (319) Walgreens # Th Ave Marion,IA (319) LOUISA Columbus Junction Drug Town Clinic Phcy #2 1091/2 Walnut St Columbus Junction,IA (319) Wapello Drug Town Clinic # N 2Nd St Wapello,IA (319) LUCAS Chariton Hy-Vee Pharmacy # Court Ave Chariton,IA (641) Pamida Pharmacy # Court Ave Chariton,IA (641) LYON Rock Rapids Lewis Family Drug # N Boone St Rock Rapids,IA (712) Lewis Family Drug # S 3Rd Ave Rock Rapids,IA (712) MADISON Winterset Medicap Pharmacy # N John Wayne Dr Winterset,IA (515) Pamida # E Highway 92 Winterset,IA (515) MAHASKA Oskaloosa Hy-Vee Pharmacy # S D St Oskaloosa,IA (641) Medicap Pharmacy # A Ave W Oskaloosa,IA (641) Wal*Mart # Rd Ave E Oskaloosa,IA (641) MARION Knoxville Hy-Vee Pharmacy # W Rock Island St Knoxville,IA (641) Medicap Pharmacy # W Pleasant St Knoxville,IA (641) Wal*Mart Phcy # W Bell Ave Knoxville,IA (641) Pella Hy-Vee Pharmacy # SE 9Th St Pella,IA (641) Pella Regional Health Ctr 404 Jefferson St Pella,IA (952) Wal*Mart # Highway 163 & 9Th St Pella,IA (641) Pleasantville Pleasantville Clinic 104 N Washington St Pleasantville,IA (952) MARSHALL Marshalltown Drug Town # S Center St Marshalltown,IA (641) Drug Town Clinic # Nicholas Dr Marshalltown,IA (641) Hy-Vee Pharmacy # S Center St Marshalltown,IA (641) K Mart # S Center St Marshalltown,IA (641) Wal*Mart # S Center St Marshalltown,IA (641) Walgreens # E Anson St Marshalltown,IA (641) MILLS Glenwood Medical Partners of Glenwood 1203 S Locust St Glenwood,IA (952) This pharmacy does not offer extended supplies of maintenance medications. IOWA 17

18 Pamida Pharmacy # S Locust St Glenwood,IA (712) MITCHELL Osage Pamida Pharmacy # Main St Osage,IA (641) MONONA Onawa Pamida Pharmacy # Hwy 175 W Onawa,IA (712) MONROE Albia Garwood Healthmarket 301 Highway 34 W Albia,IA (641) Pamida Pharmacy # Highway 34 W Albia,IA (641) MONTGOMERY Red Oak Hy-Vee Pharmacy # N Broadway St Red Oak,IA (712) MUSCATINE Muscatine Drug Town # Mulberry Ave Muscatine,IA (563) Drug Town Clinic # Mulberry Ave Muscatine,IA (563) Hy-Vee Pharmacy # Nd Ave Muscatine,IA (563) Wal*Mart # N Highway 61 Muscatine,IA (563) Walgreens #00676 U S Highway 38 & 61 Muscatine,IA (563) O'BRIEN Sheldon Lewis Family Drug # Park St Sheldon,IA (712) Pamida # Park St Sheldon,IA (712) PAGE Clarinda Medicap Pharmacy # S 16Th St Clarinda,IA (712) Shenandoah Hy-Vee Pharmacy # W Nishna Rd Shenandoah,IA (712) Wal*Mart # S Fremont St Shenandoah,IA (712) PLYMOUTH Le Mars Hy-Vee Pharmacy # Th Ave SW Le Mars,IA (712) Hy-Vee Rx 44 1St Ave NE Le Mars,IA (712) Wal*Mart # Th Ave NW Le Mars,IA (712) POCAHONTAS Laurens Hy-Vee Resslers Clinic # N 3Rd St Laurens,IA (712) POLK Altoona Hy-Vee Pharmacy # Th St SW Altoona,IA (515) Target #T Th St SW Altoona,IA (515) Wal*Mart Phcy # Th St SW Altoona,IA (515) Walgreens # Th St SE Altoona,IA (870) Ankeny Drug Town # S Ankeny Blvd Ankeny,IA (515) Hy-Vee Pharmacy # N Ankeny Blvd Ankeny,IA (515) Target #T SE Delaware Ave Ankeny,IA (515) Wal*Mart # SE National Dr Ankeny,IA (515) Walgreens # SE Delaware Ave Ankeny,IA (515) Walgreens # N Ankeny Blvd Ankeny,IA (515) Clive K Mart # University Ave Clive,IA (515) Walgreens # University Ave Clive,IA (515) Walgreens # Hickman Rd Clive,IA (515) Des Moines Care Center Phcy # High St Bldg 13 Des Moines,IA (515) IA Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications IOWA

19 IA Drug Town # University Ave Des Moines,IA (575) Wal*Mart # SE 14Th St Des Moines,IA (515) Walgreens # Ingersoll Ave Des Moines,IA (515) NCS Healthcare of Ia Inc Th St Urbandale,IA (515) Hy-Vee Pharmacy #1 (1136) 3330 Martin L King Pkwy Des Moines,IA (515) Wal*Mart # Rd St Des Moines,IA (515) Walgreens # SE 14Th Des Moines,IA (515) Target #T Plum Dr Urbandale,IA (515) Chain Pharmacies Hy-Vee Pharmacy #2 (1138) 2540 E Euclid Ave Des Moines,IA (515) Hy-Vee Pharmacy #3 (1142) 3221 SE 14Th St Des Moines,IA (515) Hy-Vee Pharmacy #4 (1148) 4707 Fleur Dr Des Moines,IA (515) Hy-Vee Pharmacy #5 (1151) 1107 SE Army Post Rd Des Moines,IA (515) K Mart # Hubbell Avrnue Des Moines,IA (515) Medicap Pharmacy # Franklin Ave Des Moines,IA (515) Medicap Pharmacy # Beaver Ave Des Moines,IA (515) Sams Pharmacy # Rd St Des Moines,IA (515) Target #T Douglas Ave Des Moines,IA (515) Walgreens # Walnut St Des Moines,IA (515) Walgreens # Fleur Dr Des Moines,IA (515) Walgreens # Douglas Ave Des Moines,IA (515) Walgreens # E University Ave Des Moines,IA (515) Walgreens # SE 14Th St Des Moines,IA (515) Walgreens # E University Ave Des Moines,IA (515) Walgreens # E University Ave Des Moines,IA (515) Walgreens # Douglas Ave # P Des Moines,IA (515) Walgreens # E Euclid Ave Des Moines,IA (515) Walgreens # E Euclid Ave Des Moines,IA (515) Grimes Drug Town Clinic # N Harvey St Grimes,IA (515) Johnston Hy-Vee Pharmacy # Merle Hay Rd Johnston,IA (515) Walgreens # Merle Hay Rd Johnston,IA (515) Pleasant Hill Hy-Vee Pharmacy # Maple Dr Pleasant Hill,IA (515) Urbandale Hy-Vee Pharmacy # Douglas Ave Urbandale,IA (515) K Mart # Hickman Rd Urbandale,IA (515) Medicap Pharmacy # Douglas Ave Urbandale,IA (515) Walgreens # Th St Urbandale,IA (515) West Des Mines Walgreens # George Mills Civic P West Des Mines,IA (515) West Des Moines Costco Pharmacy # Mills Civic Pkwy West Des Moines,IA (515) Drug Town #1 (7081) Th St West Des Moines,IA (515) Drugtown #2 (7082) Th St West Des Moines,IA (515) Hy-Vee Pharmacy #1 (1887) Th St West Des Moines,IA (515) Hy-Vee Pharmacy #2 (1888) 1990 Grand Ave West Des Moines,IA (515) Hy-Vee Pharmacy #4 (1890) 555 S 51St St West Des Moines,IA (515) This pharmacy does not offer extended supplies of maintenance medications. IOWA 19

20 Target #T Th St West Des Moines,IA (515) Target #T Mills Civic Pkwy West Des Moines,IA (515) Walgreens # Nd St West Des Moines,IA (515) Walgreens # Grand Ave West Des Moines,IA (515) Windsor Heights Hy-Vee Pharmacy # University Ave Windsor Heights,IA (515) POTTAWATTAMIE Council Bluff Sam's Pharmacy # Manawa Sentre Dr Council Bluff,IA (712) Council Bluffs Alegent Health Mercy Hospital 800 Mercy Dr Council Bluffs,IA (952) Drug Town # N 16Th St Council Bluffs,IA (712) Drug Town # W Broadway Council Bluffs,IA (712) Drug Town # Madison Ave Council Bluffs,IA (712) K Mart # Highway 6 Council Bluffs,IA (712) Medicap Phcy # W Broadway Ste 8 Council Bluffs,IA (712) No Frills Phcy Express # Valley View Dr Council Bluffs,IA (712) No Frills Phcy Express # W Broadway Council Bluffs,IA (712) Wal*Mart # Manawa Centre Dr Council Bluffs,IA (712) Walgreens # E Broadway Council Bluffs,IA (712) Walgreens # W Broadway Council Bluffs,IA (712) Walgreens # W Bennett Ave Council Bluffs,IA (712) POWESHIEK Grinnell Hy-Vee Pharmacy # West St S Grinnell,IA (641) Medicap Pharmacy # Th Ave Grinnell,IA (641) Wal*Mart # West St Grinnell,IA (641) RINGGOLD Mount Ayr Pamida Pharmacy # N Fillmore St Mount Ayr,IA (641) SCOTT Bettendorf CVS Pharmacy # Spruce Hills Dr Bettendorf,IA (563) Hy-Vee Pharmacy # Devils Glen Rd Bettendorf,IA (563) Schnucks Pharmacy 858 Middle Rd Bettendorf,IA (563) Walgreens # Middle Rd Bettendorf,IA (563) Walgreens # Middle Rd Bettendorf,IA (563) Davenport Coram Alternate Site Svcs 3513 Vine Ct Davenport,IA (563) CVS Pharmacy # W Kimberly Rd Davenport,IA (563) CVS Pharmacy # N Division St Davenport,IA (563) Hy-Vee Pharmacy #1 (1105) 3019 Rockingham Rd Davenport,IA (563) Hy-Vee Pharmacy #2 (1106) 2200 W Kimberly Rd Davenport,IA (563) Hy-Vee Pharmacy #3 (1107) 1823 E Kimberly Rd Davenport,IA (563) Hy-Vee Pharmacy #4 (1108) 4064 E 53Rd St Davenport,IA (563) Hy-Vee Pharmacy #5 (1109) 2351 W Locust St Davenport,IA (563) K Mart # W Kimberly Rd Davenport,IA (563) Kmart # N Brady St Davenport,IA (563) Omnicare of Quad Cities 2660 E 53Rd St Ste 1 Davenport,IA (563) Sam's Pharmacy # Elmore Ave Davenport,IA (563) IA Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications IOWA

21 IA Target #T Elmore Ave Davenport,IA (563) Wal*Mart Phcy # Elmore Ave Davenport,IA (563) SIOUX Rock Valley Lewis Family # Th St Rock Valley,IA (712) Sioux Center K Mart # Buckeye Ave Ames,IA (515) Target #T S Duff Ave Ames,IA (515) Medicap Pharmacy # S Sumner Ave Creston,IA (641) Wal*Mart # New York Ave Creston,IA (641) Chain Pharmacies Wal*Mart Phcy # West Kimberly Rd Davenport,IA (563) Walgreens # W Kimberly Rd Davenport,IA (563) Walgreens # E Kimberly Rd Davenport,IA (563) Walgreens # W Locust St Davenport,IA (563) Walgreens # E 53Rd St Davenport,IA (563) Walgreens # Brady St Davenport,IA (563) SHELBY Harlan Hy-Vee Pharmacy # Rd St Harlan,IA (712) Pamida Pharmacy # Chatburn Ave Harlan,IA (712) Hy-Vee Pharmacy # S Main Ave Sioux Center,IA (712) Lewis Family Drug # N Main Ave Ste 110 Sioux Center,IA (712) Wal*Mart # S Main Ave Sioux Center,IA (712) STORY Ames Drug Town # Main St Ste A Ames,IA (515) Drug Town Clinic # Duff Ave Ames,IA (515) Hy-Vee Pharmacy #1 (1013) 3800 Lincoln Way Ames,IA (515) Hy-Vee Pharmacy # Lincoln Way Ames,IA (515) Hy-Vee Pharmacy #2 (1018) 640 Lincoln Way Ames,IA (515) Wal*Mart # Grand Ave Ames,IA (515) Wal*Mart Phcy # S Duff Ave Ames,IA (505) Walgreens # Grand Ave Ames,IA (515) Huxley Hy-Vee Clinic Phcy # S Hwy 69 Ste B Huxley,IA (515) TAMA Toledo Medicap Pharmacy # Nd Ave W Toledo,IA (641) Pamida Pharmacy # S County Rd Toledo,IA (641) UNION Creston Hy-Vee Pharmacy # Sheldon St Creston,IA (641) WAPELLO Ottumwa Drug Town # N Jefferson St Ottumwa,IA (641) Econofoods Pharmacy # N Hancock St Ottumwa,IA (641) Hy-Vee Clinic Drugstore # Pennsylvania Ave Ottumwa,IA (641) Hy-Vee Pharmacy #1 (1504) 1025 N Quincy Ave Ottumwa,IA (641) Hy-Vee Pharmacy #2 (1505) 2453 N Court St Ottumwa,IA (641) K Mart # N Quincy Ave Ottumwa,IA (641) Wal*Mart # N Quincy Ave Ottumwa,IA (641) Walgreens # W 4Th St Ottumwa,IA (641) This pharmacy does not offer extended supplies of maintenance medications. IOWA 21

22 WARREN Carlisle Medicap Pharmacy # School St Carlisle,IA (515) Indianola Drug Town # E Ashland Ave Indianola,IA (515) Hy-Vee Pharmacy # N Jefferson St Indianola,IA (515) Wal*Mart # N Jefferson St Indianola,IA (515) Walgreens # N Jefferson St Indianola,IA (515) Norwalk Medicap Pharmacy # Sunset Dr Norwalk,IA (515) WASHINGTON Washington Hy-Vee Pharmacy # S Hwy #1 Washington,IA (319) Pamida # E Washington St Washington,IA (319) Wal*Mart # Highway 1 S Washington,IA (319) WEBSTER Fort Dodge Drug Town # S 25Th St Fort Dodge,IA (515) Hy-Vee Pharmacy # S 29Th St Fort Dodge,IA (515) Target #T St Ave S Fort Dodge,IA (515) Wal*Mart # St Ave S Fort Dodge,IA (515) Walgreens # Th Ave S Fort Dodge,IA (515) WINNEBAGO Forest City Pamida Pharmacy # E US Highway 9 Forest City,IA (641) WINNESHIEK Decorah Medicap Pharmacy # Montgomery St Decorah,IA (563) Wal*Mart Phcy # Old Stage Rd Decorah,IA (563) WOODBURY Sioux City Drug Town Pharmacy # Pierce St Sioux City,IA (712) Hy-Vee Pharmacy #1 (1610) 313 Cook St Sioux City,IA (712) Hy-Vee Pharmacy #2 (1614) 4500 Sergeant Rd Sioux City,IA (712) Hy-Vee Pharmacy #3 (1615) 3301 Gordon Dr Sioux City,IA (712) K Mart # E Gordon Dr Sioux City,IA (712) Shopko Pharmacy # Hamilton Blvd Sioux City,IA (712) Target T Sunnybrook Dr Sioux City,IA (712) Wal*Mart Phcy # Singing Hills Blvd Sioux City,IA (712) Wal*Mart Phcy # Floyd Blvd Sioux City,IA (712) Walgreens # Morningside Ave Sioux City,IA (712) Walgreens # Pierce St Sioux City,IA (712) IA Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications IOWA

23 Mail Order Pharmacies IOWA 23

24 Mail-Order Pharmacies Mail-Order Pharmacies Medco By Mail Contact the Medco By Mail Customer Service department using the contact information on the front cover. TTY/TDD users should call Liberty Medical TTY/TDD users should call IOWA

25 Home Infusion Pharmacies This plan will cover home infusion therapy if: Your prescription drug is on the plan s formulary or you have a formulary exception. The Plan has approved your prescription drug for home infusion therapy. Your prescription is written by an authorized prescriber. Home infusion pharmacies specialize in the preparation of medications that are administered intravenously or by injection. To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. IOWA 25

26 IOWA Accredo Therapeutics Inc 2415 Heinz Rd Iowa City,IA (319) American Home Patient Hickman Rd Ste D Des Moines,IA Coram Alternate Site Svcs 3513 Vine Ct Davenport,IA (563) Cr IV Service Inc Th St SE Ste 100 Cedar Rapids,IA (319) Iowa Care Systems Aurora Ave Urbandale,IA (515) Massena Clinic Pharmacy 92 Main St Massena,IA (712) Stangel Pharmacy Inc 821 Iowa Ave Onawa,IA (712) IA Home Infusion Pharmacies IOWA

27 Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under the Plan through the facility s longterm care pharmacy or another network long-term care pharmacy. A long-term care pharmacy provides medications to residents of long-term care facilities (such as nursing homes and residential care facilities, mental health facilities, hospices, and long-term care or skilled nursing care beds in hospitals). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. IOWA 27

28 IOWA Advocare Pharmacy #2 621 Broad St Ste 100 Story City,IA (515) Atlantic Medical Phcy Inc 1501 E 10Th St Atlantic,IA (712) Carroll Clinic Nursing Home Phar 405 S Clark St Ste 150A Carroll,IA (712) Cligman Pharmacy 106 E 4Th St Vinton,IA (319) Clinton Med Clinic Phcy 221 Main Ave Clinton,IA (563) Community Pharmacy 507 E Lake St Rockwell City,IA (712) Community Pharmacy 1301 W Main St Lake City,IA (712) Community Pharmacy Ii 1800 Main St Gowrie,IA (515) Community Pharmacy Iii Rd St Lake View,IA (712) Connors Clinic Pharmacy 1501 S Main St Charles City,IA (641) Daniel Pharmacy 1114 Central Ave Fort Dodge,IA (515) Dewitt Pharmacy Inc 609 7Th Street De Witt,IA (563) Disco Drug-Med Arts Div Nd Ave N Fort Dodge,IA (515) Dowd Drug Inc 307 State St Guthrie Center,IA (641) Drug Town # Cedar Mall Charles City,IA (641) Drug Town # E Main St Cherokee,IA (712) Drug Town # W Burlington Ave Fairfield,IA (641) Drug Town # S 25Th St Fort Dodge,IA (515) Drug Town # N Wilson St Jefferson,IA (515) Drug Town # Th Ave Marion,IA (319) Drug Town # S Jefferson St Mt Pleasant,IA (319) Drug Town # St Ave E Newton,IA (641) Drug Town # Mulberry Ave Muscatine,IA (563) Drug Town # N Jefferson St Ottumwa,IA (641) Drug Town Clinic # N 2Nd St Wapello,IA (319) Drug Town Clinic (7028-1) 321 Main Marcus,IA (712) Drug Town Pharmacy # Pierce St Sioux City,IA (712) Economed of Ia Aurora Ave Urbandale,IA (000) Estherville Snyder Drug 522 Central Ave Estherville,IA (712) Fedders Healthmart 52 Main Ave N Britt,IA (641) Friendship Haven Phcy S Kenyon Road Fort Dodge,IA (515) Garwood Healthmarket 11 S Clinton St Albia,IA (641) Guttenberg Pharmacy Inc 807 S Highway 52 Guttenberg,IA (563) Hartig Nursing Home Svcs 2216 Woodland Dr Dubuque,IA (563) Heritage Partners Pharmacy 1223 S Gear Ave West Burlington,IA (319) Hicks Pharmacy 113 N 9Th St Adel,IA (515) Hoines Drug Store 113 N Elm St Cresco,IA (563) Hughes Pharmacy 2216 Main St Emmetsburg,IA (712) Hy-Vee Pharmacy # US Highway 169 N Algona,IA (515) Hy-Vee Pharmacy # E 7Th St Atlantic,IA (712) Hy-Vee Pharmacy # Th St Boone,IA (515) Hy-Vee Pharmacy # N 18Th St Centerville,IA (641) Hy-Vee Pharmacy # Central Ave Estherville,IA (712) IA Long-Term Care Pharmacies IOWA

29 IA Long-Term Care Pharmacies Hy-Vee Pharmacy # Th Ave N Humboldt,IA (515) Hy-Vee Pharmacy # W Rock Island St Knoxville,IA (641) Hy-Vee Pharmacy # Th Ave SW Le Mars,IA (712) Hy-Vee Pharmacy # S Center St Marshalltown,IA (641) Hy-Vee Pharmacy # S White St Mount Pleasant,IA (319) Hy-Vee Pharmacy # S D St Oskaloosa,IA (641) Hy-Vee Pharmacy # SE 9Th St Pella,IA (641) Hy-Vee Pharmacy # Th St Perry,IA (515) Hy-Vee Pharmacy # N Broadway St Red Oak,IA (712) Hy-Vee Pharmacy # S Main Ave Sioux Center,IA (712) Hy-Vee Pharmacy # Th St Spirit Lake,IA (712) Hy-Vee Pharmacy # Lake Ave Storm Lake,IA (712) Hy-Vee Pharmacy # Th Ave SW Spencer,IA (712) Hy-Vee Pharmacy Th St SW Mason City,IA (641) Hy-Vee Rx 44 1St Ave NE Le Mars,IA (712) Kindred Pharmacy Services Th St Urbandale,IA (515) La Grange Pharmacy 111 W 4Th St Vinton,IA (319) Lutz Long Term Care Pharmacy 120 8Th St SE Ste B Altoona,IA (515) Lutz Pharmacy 120 8Th St SE Altoona,IA (515) Main Healthcare Services 2151 Kimberly Rd Bettendorf,IA (563) Manly Drug Store 621 G Ave Grundy Center,IA (319) Manning Pharmacy Inc 317 Main St Manning,IA (712) Martin Health Services 130 W Fayette St / PO Box C Denver,IA (319) Mc Mahon Drug Store 625 Davis Ave Corning,IA (641) Medicap Pharmacy # Franklin Ave Des Moines,IA (515) Medicap Pharmacy # S Frederick Ave Oelwein,IA (319) Medicap Pharmacy # W Washington St Mt Pleasant,IA (319) Medicap Pharmacy # E 6Th St Carroll,IA (712) Medicap Pharmacy # S 1St St Perry,IA (515) Medicap Pharmacy # S Sumner Ave Creston,IA (641) Medicap Pharmacy # E Euclid Ave Indianola,IA (515) Medicap Pharmacy # W Pleasant St Knoxville,IA (641) Medicap Pharmacy # S 16Th St Clarinda,IA (712) Medicap Pharmacy # Broadway St Audubon,IA (712) Medicap Pharmacy # E 14Th St Des Moines,IA (515) Medicap Pharmacy # N John Wayne Dr Winterset,IA (515) Medicap Pharmacy # A Ave W Oskaloosa,IA (641) Medicap Pharmacy # Nd Ave SW Cresco,IA (563) Medicap Pharmacy # Th Ave Grinnell,IA (641) Medicap Pharmacy # Story St Boone,IA (515) Medicap Pharmacy # E Main St Panora,IA (641) Medicap Pharmacy # Th Ave Manson,IA (712) Medicap Pharmacy # N Elm St Jefferson,IA (515) Medicap Pharmacy # Nd Ave W Toledo,IA (641) IOWA 29

30 Medicap Pharmacy # St Ave W Newton,IA (641) Medicap Pharmacy # Sunset Dr Norwalk,IA (515) Medicap Pharmacy # Waterloo Rd Cedar Falls,IA (319) Medicap Pharmacy # Th St Dallas Center,IA (515) Medicap Pharmacy # Senate Ave Red Oak,IA (712) Medicap Pharmacy # Montgomery St Decorah,IA (563) Medicap Pharmacy # S Oak St Iowa Falls,IA (641) Medicap Pharmacy # Beaver Ave Des Moines,IA (515) Medicap Pharmacy # Annex Rd Madrid,IA (515) Medicap Pharmacy # N 18Th St Centerville,IA (641) Medicap Pharmacy # Grand Ave West Des Moines,IA Medicap Pharmacy # NE Delaware Ave Ankeny,IA (515) Medicap Pharmacy # Th St Altoona,IA (515) Medicap Pharmacy # E Euclid Ave Indianola,IA (515) Medicap Pharmacy # Edgington Ave Eldora,IA (641) Mercy Caremor 535 Hill St Dubuque,IA (563) Mercy Long Term Care Phcy 621 S Illinois Ave #104 Mason City,IA (641) Mercy Specialty Care Phcy Th St Ste 4 Des Moines,IA (515) Moser Family Pharmacy 135 North Main Elkader,IA (563) NCS Healthcare of Ia Inc Th St Urbandale,IA (515) Nu Cara Pharmacy # Center St Conrad,IA (641) Nu Cara Pharmacy # Th St Coralville,IA (319) Nucara Pharmacy Ltc 3994 NW Urbandale Dr Urbandale,IA (515) Omnicare of Quad Cities 2660 E 53Rd St Ste 1 Davenport,IA (563) Osterhaus Phcy Inc 124 S Main St Maquoketa,IA (563) Pamida # Park St Sheldon,IA (712) Pamida # E Highway 92 Winterset,IA (515) Pamida Pharmacy # Hwy 175 W Onawa,IA (712) Pamida Pharmacy # W Milwaukee St New Hampton,IA (641) Pamida Pharmacy # Sunnyside Ln Atlantic,IA (712) Pamida Pharmacy # E US Highway 9 Forest City,IA (641) Pamida Pharmacy # Highway 34 W Albia,IA (641) Pamida Pharmacy # W Huron St Missouri Valley,IA (712) Pamida Pharmacy # N Fillmore St Mount Ayr,IA (641) Pexton Drug Store 1812 Chatburn Plz Harlan,IA (712) Pharmacy Care Associates Th Ave SW Cedar Rapids,IA (319) Pharmacy Care Centre 1791 Highway 64 E # 1 Anamosa,IA (319) Pocahontas Pharmacy 701 W Elm Ave Pocahontas,IA (712) Sac City Drug 514 W Main St Sac City,IA (712) Schuchmanns Pharmacy Inc 12 S Frederick Ave Oelwein,IA (319) Scott Pharmacy 238 S Main St Fayette,IA (563) Sheffield Pharmacy 115 Gilman St Sheffield,IA (641) Shopko Pharmacy # John F Kennedy Rd Dubuque,IA (563) Stangel Pharmacy Inc 821 Iowa Ave Onawa,IA (712) IA Long-Term Care Pharmacies IOWA

31 IA Stangel Pharmacy Ltc 821 Iowa Ave Onawa,IA (712) Union Prescription Center 235 W Broadway Council Bluffs,IA (712) Steege Pharmacy 119 N Vine St West Union,IA (563) Strawberry Point Drug Inc 104 E Mission St Strawberry Pt,IA Sun Pharmacy 6105 Merle Hay Rd Johnston,IA (515) Valumed Pharmacy 224 4Th St Ste 100 Sioux City,IA (712) Valuscript Pharmacy 4105 Westcor Ct Ste 1 Coralville,IA (000) Verhelst Drug Center 98 10Th St N Northwood,IA (641) Long-Term Care Pharmacies The Medicine Shoppe 212 1St St N Newton,IA (641) The Riceville Pharmacy 120 W Main St Riceville,IA (641) Thrifty White Drug # Willson Ave Webster City,IA (515) Thrifty White Drug # Broadway Denison,IA (712) West End Drug Inc 105 W Main St Ste 102 Ottumwa,IA (641) Wester Drug 315 E 2Nd St Muscatine,IA (563) White Drug # S Grand Ave Spencer,IA (712) Widner Drug Store 111 S Franklin St Manchester,IA (563) Thrifty White Drug #64 2 N 4Th St Clear Lake,IA (641) Ump Clinic Pharmacy 1717 W Ridgeway Ave Waterloo,IA (319) Union Drug Inc 315 Highway 150 N West Union,IA (563) Williams Drugs 611 2Nd St Webster City,IA (515) Wrightway Ltc Pharmacy 200 5Th Ave S Clinton,IA (563) Your Med Ltc 4946 Franklin Ave Des Moines,IA IOWA 31

32

33 MINNESOTA

34

35 Retail Pharmacies MINNESOTA 35

36 AITKIN Aitkin MINNESOTA Thrifty White Pharmacy 25 2Nd St NE Aitkin,MN (218) ANOKA Coon Rapids Hanson Northdale Drug 544 Northdale Blvd NW Coon Rapids,MN (763) BECKER Ogema White Earth Health Center Cty Hwy 34 Ogema,MN BELTRAMI Redlake Red Lake Ihs Pharmacy PO Box 160 Redlake,MN (218) BENTON Foley Foley Rexall Drug Company PO Box 217 Foley,MN (320) Sartell Country Manor Ltc Pharmacy 520 1St St NE Ste A Sartell,MN (320) Sauk Rapids Option Care 1000 S Benton Dr Ste 405 Sauk Rapids,MN (320) Village Pharmacy & Gift 108 2Nd Ave S Sauk Rapids,MN (320) BLUE EARTH Mapleton Mapleton Drug 404 Main St E Mapleton,MN (507) BROWN Sleepy Eye Randy's Family Drug 121 1St Ave S Sleepy Eye,MN (507) CARLTON Cloquet Min No Aya Win Clinic Phy 927 Trettel Ln Cloquet,MN (218) The Medicine Shoppe # Cloquet Ave Cloquet,MN (218) The Medicine Shoppe # Skyline Blvd Cloquet,MN (218) CARVER Chanhassen Park Nicollet Pharmacy-Chanhasse 300 Lake Dr E Chanhassen,MN (952) Waconia Waconia Pharmacy 430 Highway 5 West Waconia,MN (952) Watertown Watertown Pharmacy 204 Lewis Ave S Ste 101 Watertown,MN (952) CASS Cass Lake Cass Lake Hospital 317 7Th St NW Cass Lake,MN (218) Pine River Lakes Area Pharmacy 417 Barclay Ave Pine River,MN (218) CHISAGO Lindstrom Lindstrom Snyder Drug Lincoln Rd Lindstrom,MN (651) North Branch Country Valu Mn Inc 6445 Main St North Branch,MN (651) CLAY Moorhead Coram Altemate Site Services Inc 2901 S Frontage Rd Ste 7 Moorhead,MN (218) Moorhead Drug Company 420 Center Ave Moorhead,MN (218) COTTONWOOD Westbrook Lichty Drug 601 1St Ave Westbrook,MN (507) CROW WING Brainerd Arrowhead Pharmacy 108 S 6Th St Brainerd,MN (218) The Medicine Shoppe # S 6Th St Brainerd,MN (218) Pequot Lakes Lake Area Pharmacy 4291 Main St Pequot Lakes,MN (218) DAKOTA Burnsville Health One Pharmacy Msp Inc 414 Gateway Blvd Burnsville,MN (952) MN Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 36 MINNESOTA 133

37 MN Retail Pharmacies Park Nicollet Pharmacy-Burnsvill Fairview Dr Burnsville,MN (952) Eagan Park Nicollet Pharmacy-Eagan 1885 Plaza Dr Eagan,MN (952) Saint Paul Muller Valu-Rite Pharmacy 368 Bernard St W Saint Paul,MN (651) The Medicine Shoppe # Robert St S Saint Paul,MN (651) FILLMORE Rushford Witt's Pharmacy-Ltc 213 S Mill St Rushford,MN (507) FREEBORN Albert Lea Albert Lea Medical Ctr O/P Pharm 404 W Fountain St Albert Lea,MN (507) GOODHUE Cannon Falls Scofield Drugs & Gifts 108 4Th St N Cannon Falls,MN (507) Kenyon Bergh Pharmacy 103 Red Wing Ave Kenyon,MN (507) Red Wing Corner Medical Center Phy 701 Fairview Blvd #2116 Red Wing,MN (651) Red Wing Corner Drug 401 W 3Rd St Red Wing,MN (651) GRANT Elbow Lake Pharmcare LLC 930 1St St NE Elbow Lake,MN (218) Herman Herman Clinic Pharmacy 204 5Th St E Herman,MN (320) HENNEPIN Bloomington Geritom Med Pharmacy 1631 E 79Th St Ste 142 Bloomington,MN (952) Park Nicollet Pharmacy-Bloomingt 5320 Hyland Greens Dr Bloomington,MN (952) Brooklyn Center Park Nicollet Pharmacy-Brookdale 6000 Earle Brown Dr Brooklyn Center,MN (952) Hopkins Apria Pharmacy-Minnetonka 131 Cheshire Ln Ste 500 Hopkins,MN (800) Maple Plain Maple Plain Drug 1500 Howard Ave Maple Plain,MN (763) Minneapolis Franklin Drugs 2423 E Franklin Ave Minneapolis,MN (612) Merwin Ltc Pharmacy # Th Ave S Apt 16 Minneapolis,MN (612) North Point Health Center Pharma 1313 Penn Ave N Minneapolis,MN (612) Park Nicollet Pharmacy-Minneapol 2001 Blaisdell Ave South Minneapolis,MN (952) Schneider Drug 3400 University Ave SE Minneapolis,MN (612) United Phcy Associates 5534 Lakeland Ave N Minneapolis,MN (763) Minnetonka Park Nicollet Pharmacy-Carlson Oaks Center Dr Minnetonka,MN (952) Park Nicollet Pharmacy-Minnetonk Highway 7 Minnetonka,MN (952) New Hope St Therese Pharmacy 8000 Bass Lake Rd New Hope,MN (612) Plymouth Park Nicollet Pharmacy-Plymouth 3007 Harbor Ln N Plymouth,MN (952) Saint Louis Park Methodist Hospital Phcy 6500 Excelsior Blvd Saint Louis Park,MN (952) Park Nicollet Pharmacy-Meadowbro 6490 Excelsior Blvd Saint Louis Park,MN (952) Park Nicollet Phcy-St Louis Park 3800 Park Nicollet Blvd Saint Louis Park,MN (952) Wayzata Park Nicollet Pharmacy-Wayzata 250 Central Ave N Wayzata,MN (952) Wolfs Wayzata Pharmacy 1310 Wayzata Blvd E Ste D Wayzata,MN (952) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 37

38 ISANTI Cambridge Anderson Drug 113 Main St S Cambridge,MN (763) Merwin Ltc Pharmacy #3 100 Buchanan St N Ste B Cambridge,MN (763) ITASCA Bigfork Bigfork Valley Pharmacy 258 Pine Tree Dr Bigfork,MN (218) Grand Rapids The Medicine Shoppe # NE 4Th St Grand Rapids,MN (218) KOOCHICHING Intl Falls City Drug Store 314 3Rd St Intl Falls,MN (218) LE SUEUR Le Sueur Corner Drugs 204 Valley Green Sq Le Sueur,MN (651) Montgomery Herrmann Drug Inc 120 1St St S Montgomery,MN (507) LINCOLN Hendricks Siverson Drug Store Ltd 118 S Main St Hendricks,MN (507) Ivanhoe Ivanhoe Family Pharmacy 366 E George St Ste 1 Ivanhoe,MN (507) MEEKER Litchfield The Medicine Shoppe # E Highway 12 Litchfield,MN (320) MILLE LACS Onamia Mille Lacs Hospital Pharmacy 200 Elm St N Onamia,MN (320) Onamia Drug 516 Main St Onamia,MN (320) MORRISON Little Falls The Medicine Shoppe # St St SE Little Falls,MN (320) Wolff's Mushel Drug 101 1St St SE Little Falls,MN (320) Pierz Wolff Drug 207 Main St Pierz,MN (320) MOWER Austin St Olaf Hospital St Dr NW Austin,MN (507) MURRAY Slayton Slayton Drug 2622 Broadway Ave Slayton,MN (507) NOBLES Worthington The Medicine Shoppe # Th Ave Worthington,MN (507) OLMSTED Rochester Hunt Silver Lake Drug 1510 N Broadway Rochester,MN (507) Mayo Clinic Pharmacy 21 2Nd St SW Rochester,MN (507) Mayo Clinic Pharmacy 1216 Second St SW Rochester,MN (507) Mayo Clinic Pharmacy 201 W Center St Rochester,MN (507) Mayo Clinic Pharmacy NE 3041 Stronehedge Dr NE Rochester,MN (507) Mayo Pharmacy Baldwin 221 4Th Ave SW Rochester,MN (507) Mayo Pharmacy NW St Ave NW Rochester,MN (507) The Medicine Shoppe # N Broadway Rochester,MN (507) OTTER TAIL Battle Lake Seip Drug #5 113 Lake Ave N Battle Lake,MN (218) Village Apothecary 113 Lake Ave N Battle Lake,MN (218) Pelican Rapids Pelican Drug 11 N Broadway Pelican Rapids,MN (218) Perham Seip Prescription Shoppe #6 211 Market Drive Perham,MN (218) MN Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

39 MN Retail Pharmacies PIPESTONE Pipestone Pipestone County Medical Center 916 4Th Ave SW Pipestone,MN (507) POLK Fosston Nords Pharmacy & Gifts 115 Johnson Ave N Fosston,MN (218) POPE Glenwood Clenwood Corner Drug Inc 1 Minnesota Ave E Glenwood,MN (651) Starbuck Samuelsons Drug 118 E 5Th St Starbuck,MN (320) RAMSEY Maplewood Oakdale Pharmacy 2730 Stillwater Rd E Maplewood,MN (651) Moundsview Rx Express 8400 Coral Sea St NE Ste 500 Moundsview,MN (763) New Brighton Merwin Ltc Pharmacy # Old Highway 8 NW # B New Brighton,MN (651) Preferred Choice Phcy Inc 900 Long Lake Rd Ste 150 New Brighton,MN (651) Roseville Heartland Home Healthcare 1752 Terrace Dr Roseville,MN (651) Option Care Enterprises Inc 2750 Arthur St Roseville,MN (651) Pediatric Home Respiratory Servi 2800 Cleveland Ave N Roseville,MN (651) Saint Paul A/M Corner Drug 817 Maryland Ave E Saint Paul,MN (651) Children's Hospital's 345 Smith Ave N Saint Paul,MN (651) Genoa Healthcare Minnesota 317 York Ave Saint Paul,MN (651) Genoa Healthcare Minnesota LLC 1821 University Ave W # N464 Saint Paul,MN (651) Gillett Children's Healthcare 200 University Ave E Saint Paul,MN (651) Pro Pharmacy 242 Cleveland Ave S Saint Paul,MN (651) Regions Hospital 640 Jackson St Saint Paul,MN (651) West Side Community Hlth 153 Concord St Saint Paul,MN (651) White Bear Lake Medicine Chest Phcy & Cam Th St White Bear Lake,MN (651) REDWOOD Lamberton City Drug 210 S Main St Lamberton,MN (507) RICE Faribault Healthcare Campus Pharmacy One 200 State Ave Faribault,MN (507) SAINT LOUIS Babbitt Babbitt Drug 43 Central Blvd Babbitt,MN (218) Cook Cook Hospital Pharmacy 10 5Th St SE Cook,MN (218) Duluth Arrow Assisted Living Pharmacy 109 N 2Nd Ave W Ste 200 Duluth,MN (218) Falk's Nursing Service 221 E 14Th St Duluth,MN (218) Fond Du Lac Cair Pharmacy 211 W 4Th St Duluth,MN (218) Medical Arts Pharmacy Inc 324 W Superior St Duluth,MN (218) Ely Ely Community Pharmacy 328 W Conan St Ely,MN (218) Hibbing Baron's Pharmacy 1120 E 34Th St Hibbing,MN (218) Nett Lake Bois Forte Band Nett Lake Rd Nett Lake,MN (201) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 39

40 Virginia Virginia Regional Medical 901 9Th St N Virginia,MN (218) SCOTT Savage Coagulife Pharmacy 8690 Eagle Creek Pkwy Savage,MN (952) Shakopee Park Nicollet Pharmacy-Shakopee 1415 Saint Francis Ave Shakopee,MN (952) SHERBURNE Becker Becker Clinic Pharmacy Rolling Ridge Rd Becker,MN (763) STEARNS Paynesville Paynesville Corner Drug 122 Washburne Ave Paynesville,MN (320) Saint Cloud Centra Care Phcy Heartlnd 1520 Whitney Ct Saint Cloud,MN (320) Centracare Th Ave N Saint Cloud,MN (320) Centracare Phcy Hlth Plz 1900 Centracare Cir # 1350 Saint Cloud,MN (320) Critical Care Systems Inc Th St S Ste 101 Saint Cloud,MN (320) Hapeth Prescription Shop NW 4544 County Road 134 Saint Cloud,MN (320) Hapeth Prescription Shop S Rd St S Saint Cloud,MN (320) Health Partners Central Th St N Saint Cloud,MN (320) Sauk Centre Winters Main Street Drugs 300 Main St S Sauk Centre,MN (320) STEELE Owatonna Sterling Long Term Nd St SE Owatonna,MN (507) TODD Bertha Schultz Drug 124 2Nd Ave W Bertha,MN (218) Long Prairie The Medicine Shoppe # Central Ave Long Prairie,MN (320) WABASHA Lake City Kennedy Snyder Drug 223 S Lakeshore Dr Lake City,MN (651) Wabasha St Elizabeth Medical Center Phcy Th Grant Blvd Wabasha,MN (651) WADENA Staples Lakewood Health System Hospital County 83 Staples,MN (218) Wadena The Medicine Shoppe # Jefferson St N Wadena,MN (218) Tri-County Hospital 415 Jefferson St N Wadena,MN (218) WASECA Janesville Cahill Pharmacy 131 N Main St Janesville,MN (507) WASHINGTON Stillwater Lakeview Hospital Phcy 927 Churchill St W Stillwater,MN (651) Lakeview Outpatient Phcy 927 Churchill St W Stillwater,MN (651) WINONA Winona Goltz Pharmacy 274 E 3Rd St Winona,MN (507) Winona Clinic Pharmacy 859 Mankato Ave Winona,MN (507) WRIGHT Annandale Arenson Health Mart Pharmacy 43 Oak Ave N Annandale,MN (320) MN Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

41 Chain Pharmacies MINNESOTA 41

42 AITKIN Aitkin MINNESOTA Pamida # Southgate Dr Aitkin,MN (218) ANOKA Andover CVS Pharmacy # Bunker Lake Blvd NW Andover,MN (763) Target #T Bunker Lake Blvd NW Andover,MN (763) Walgreens # Bunker Lake Blvd NW Andover,MN (763) Anoka K Mart # W Highway 10 Anoka,MN (763) Walgreens # S Ferry St Anoka,MN (763) Blaine Cub Pharmacy # Central Ave NE Blaine,MN (763) Cub Pharmacy # Northtown Dr NE Blaine,MN (763) Cub Pharmacy # Pheasant Ridge Dr NE Blaine,MN (763) CVS Pharmacy # Th Lane NE Blaine,MN (763) K Mart # University Ave NE Blaine,MN (763) Mendota Healthcare Baltimore St NE Blaine,MN (763) Rainbow Pharmacy # Th Ln NE Blaine,MN (763) Target T Th Ave NE Blaine,MN (763) Wal*Mart Phcy # Pheasant Ridge Dr NE Blaine,MN (763) Walgreens # Highway 10 NE Blaine,MN (763) Walgreens # Aberdeen St NE Blaine,MN (763) Walgreens # Pheasant Ridge Dr NE Blaine,MN (651) Walgreens # Central Ave NE Blaine,MN (763) Circle Pines Walgreens # Lake Dr Circle Pines,MN (763) Coon Rapids Costco Pharmacy # Riverdale Blvd NW Coon Rapids,MN (763) Cub Pharmacy # Northdale Blvd NW Coon Rapids,MN (763) Cub Pharmacy # Riverdale Dr NW Coon Rapids,MN (763) CVS Pharmacy # Coon Rapids Blvd NW Coon Rapids,MN (763) Hlthpartners Coon Rapids Robinson Dr NW Coon Rapids,MN (763) Mercy Hospital 4050 Coon Rapids Blvd NW Coon Rapids,MN (952) Rainbow Pharmacy # Th Ave NW Coon Rapids,MN (763) Target #T Springbrook Dr NW Coon Rapids,MN (763) Target #T Th Ave NW Coon Rapids,MN (763) Wal*Mart # Riverdale Dr NW Coon Rapids,MN (763) Walgreens # Coon Rapids Blvd NW Coon Rapids,MN (763) Walgreens # University Ave NW Coon Rapids,MN (763) Walgreens # River Rapids Dr NW Coon Rapids,MN (763) Forest Lake Cub Pharmacy # W Broadway Ave Forest Lake,MN (651) Fridley Cub Pharmacy # Th Ave NE Fridley,MN (763) CVS Pharmacy # University Ave NE Fridley,MN (763) Pharmerica # E River Rd Ste 201 Fridley,MN (763) Sams Pharmacy # University Ave NE Fridley,MN (763) Wal*Mart # University Ave NE Fridley,MN (763) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 42 MINNESOTA 803

43 MN Chain Pharmacies Walgreens # University Ave NE Fridley,MN (763) Hilltop Walgreens # Central Ave NE Hilltop,MN (763) Lino Lakes Target #T Apollo Dr Lino Lakes,MN (651) Minneapolis CVS Pharmacy # University Ave NW Minneapolis,MN (763) Target #T Rd Ave NE Minneapolis,MN (763) Ramsey Coborn's Pharmacy # Sunwood Dr Ramsey,MN (763) BECKER Detroit Lakes K Mart # Highway 10 W Detroit Lakes,MN (218) Wal*Mart Phcy # Highway 10 W Detroit Lakes,MN (218) White Drug # Washington Ave Detroit Lakes,MN (218) Lake Park Thrifty White Drug # Nd St Lake Park,MN (218) BELTRAMI Bemidji K Mart # Highway 2 West Bemidji,MN (218) Pamida # Paul Bunyan Dr S Bemidji,MN (218) Target #T Paul Bunyan Dr NW Bemidji,MN (218) Thrifty White Phcy # Paul Bunyan Dr NW Bemidji,MN (218) Thrifty-White # Paul Bunyan Dr NW Bemidji,MN (218) Wal*Mart Phcy # Paul Bunyan Dr NW Bemidji,MN (218) Walgreens # Paul Bunyan Dr Bemidji,MN (218) BENTON Foley Coborn's Pharmacy #2 161 Glen St Foley,MN (320) Saint Cloud Shopko Pharmacy # Highway 10 SE Saint Cloud,MN (320) Target #T Lincoln Ave SE Saint Cloud,MN (320) Sauk Rapids Coborn's Pharmacy # St St S Sauk Rapids,MN (320) Walgreens # S Benton Dr Sauk Rapids,MN (320) BLUE EARTH Mankato Cub Pharmacy # E Madison Ave Mankato,MN (507) Cub Pharmacy # S Riverfront Dr Mankato,MN (507) Hy-Vee Pharmacy # S Riverfront Dr Mankato,MN (507) Hy-Vee Pharmacy # Adams St Mankato,MN (507) Immanuel St Joseph's Hospital 1025 Marsh St Mankato,MN (952) Shopko Pharmacy # E Madison Ave Mankato,MN (507) Target #T Adams St Mankato,MN (507) Wal*Mart # E Madison Ave Mankato,MN (507) Walgreens #40573 Trunk Highway 14 Mankato,MN (507) BROWN New Ulm Cashwise Pharmacy # Westridge Rd New Ulm,MN (507) Hy-Vee Pharmacy # S Broadway St New Ulm,MN (507) K Mart # N Garden St New Ulm,MN (507) New Ulm Medical Center Th St N New Ulm,MN (952) Thrifty-White # Center St New Ulm,MN (507) Wal*Mart Phcy # Westridge Rd New Ulm,MN (507) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 43

44 Walgreens # N Broadway St New Ulm,MN (503) Springfield Thrifty White # S Marshall Ave Springfield,MN (507) CARLTON Cloquet Wal*Mart # Highway 33 S Cloquet,MN (218) White Mart #0107 Pinetree Plaza Mall Cloquet,MN (218) Moose Lake Thrifty White Drug # Arrowhead Ln Moose Lake,MN (218) CARVER Chanhassen Cub Pharmacy # Market Blvd Chanhassen,MN (952) CVS Pharmacy # Galpin Blvd Chanhassen,MN (952) Prairie Stone #2 800 W 78Th St Chanhassen,MN (952) Target #T W 78Th St Chanhassen,MN (952) Walgreens # W 79Th St Chanhassen,MN (952) Chaska Crossroads Medical Center 3000 N Chestnut St Ste120 Chaska,MN (952) Rainbow Pharmacy # Pioneer Trl Chaska,MN (952) Target #T Pioneer Trail Chaska,MN (952) Walgreens # W Highway 212 Chaska,MN (952) Waconia Ridgeview Medical Center 500 S Maple St Waconia,MN (952) Ridgeview Medical Center 500 S Maple St Waconia,MN (952) Walgreens # Depot Dr Waconia,MN (952) CASS Longville Longville Lakes Clinic 180 Jordan Ln Longville,MN (952) Walker Thrifty White Drug # Minnesota Ave W Walker,MN (218) Thrifty White Drug # Michigan Ave W Walker,MN (218) CHIPPEWA Montevideo Thrifty White Phcy # E Highway 7 Montevideo,MN (320) Wal*Mart # E Highway 7 Montevideo,MN (320) CLAY Dilworth Wal*Mart # Highway 10 W Dilworth,MN (218) Moorhead Cash Wise Pharmacy # Highway 10 E Moorhead,MN (218) CVS Pharmacy # Th Ave S Moorhead,MN (218) K Mart # Highway 10 E Moorhead,MN (218) Sun Mart Pharmacy # Th St S Moorhead,MN (218) Target #T Highway 10 E Moorhead,MN (218) Walgreens # Main Ave Moorhead,MN (218) CLEARWATER Bagley Thrifty White Drug # North Main Bagley,MN (218) Clearbrook Thrifty White Drug # Main St Clearbrook,MN (218) COTTONWOOD Windom Lewis Family Drug # St Ave Windom,MN (507) Pamida # St Ave N Windom,MN (507) CROW WING Baxter Cub Pharmacy # Edgewater Dr N Baxter,MN (218) Target #T Dellwood Dr N Baxter,MN (218) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

45 MN Chain Pharmacies Brainerd Cub Pharmacy # Th Ave NE Brainerd,MN (218) Nystrom Thrifty Drug 223 S 8Th St Brainerd,MN (218) Nystrom Thrifty Drug # Th St S Brainerd,MN (218) St Joseph's Medical Center 523 N 3Rd St Brainerd,MN (952) Wal*Mart # Edgewood Dr N Brainerd,MN (218) Walgreens # W Washington St Brainerd,MN (218) Crosby Cuyuna Regional Med Ctr 320 E Main St Crosby,MN (218) DAKOTA Apple Valley Cub Pharmacy # Cedar Ave Apple Valley,MN (952) CVS Pharmacy # Galaxie Ave Apple Valley,MN (952) CVS Pharmacy # Dove Trail Apple Valley,MN (952) Hlthpartners Apple Valley Pennock Ln Apple Valley,MN (952) Rainbow Pharmacy # Cedar Ave Apple Valley,MN (952) Sams Pharmacy # Florence T Trail Apple Valley,MN (952) Target #T Cedar Ave Apple Valley,MN (952) Target #T Pilot Knob Rd Apple Valley,MN (952) Wal*Mart Phcy # Th St W Apple Valley,MN (952) Walgreens # Cedar Ave Apple Valley,MN (952) Burnsville Cub Pharmacy # County Road 42 W Burnsville,MN (952) Cub Pharmacy # Highway 13 W Burnsville,MN (952) Kmart Pharmacy # Burnhaven Dr Burnsville,MN (952) Prairiestone # County Road 42 E Burnsville,MN (952) Target #T County Road 42 W Burnsville,MN (952) Walgreens # Lac Lavon Dr Burnsville,MN (952) Walgreens # Morgan Ave S Burnsville,MN (952) Walgreens # Highway 13 E Burnsville,MN (952) Eagan Accredo Therapeutics Inc 2915 Waters Rd Ste 109 Eagan,MN (651) Cub Pharmacy # Cliff Lake Rd Eagan,MN (952) CVS Pharmacy # Johnny Cake Rd Eagan,MN (651) Prairie Stone # Promenade Pl Eagan,MN (651) Rainbow Pharmacy # Town Centre Dr Eagan,MN (651) Sams Pharmacy # Denmark Ave Eagan,MN (651) Target #T Cliff Rd Eagan,MN (952) Wal*Mart # Town Centre Dr Eagan,MN (952) Walgreens # Cliff Rd Eagan,MN (651) Walgreens # Lexington Ave S Eagan,MN (651) Walgreens # Town Centre Dr Eagan,MN (952) Farmington CVS Pharmacy # Pilot Knob Rd Farmington,MN (651) Econofoods Pharmacy # Elm St Farmington,MN (651) Hastings Coborn's Pharmacy # Rd St W Hastings,MN (651) Cub Pharmacy # Market Blvd Hastings,MN (651) Regina Medical Center 1285 Nininger Rd Hastings,MN (952) Thrifty-White # Vermillion St Hastings,MN (651) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 45

46 Wal*Mart Phcy # No Frontage Hastings,MN (651) Walgreens # Vermillion St Hastings,MN (651) Inver Grove Walgreens # Cahill Ave Inver Grove,MN (651) Inver Grove Heights Cub Pharmacy # Cahill Ave Inver Grove Heights,MN (651) Hlthpartners Inver Gr Hgt 5625 Cenex Dr Inver Grove Heights,MN (651) Wal*Mart Phcy # Cahill Ave Inver Grove Heights,MN (651) Wal*Mart Phcy # Hudson Rd Inver Grove Heights,MN (651) Walgreens # Broderick Blvd Inver Grove Heights,MN (651) Walgreens # S Robert Trl Inver Grove Heights,MN (651) Lakeville Cub Pharmacy # Th St Lakeville,MN (952) Cub Pharmacy # Heritage Dr Lakeville,MN (952) CVS Pharmacy # Dodd Blvd Lakeville,MN (952) CVS Pharmacy # Kenwood Trl Lakeville,MN (952) Rainbow Pharmacy # Kenwood Trl Lakeville,MN (952) Target #T Kenrick Ave Lakeville,MN (952) Walgreens # Th St West Lakeville,MN (952) Walgreens # Kenwood Trl Lakeville,MN (952) Mendota Hts Coram Alternate Site Svcs 2345 Waters Dr Mendota Hts,MN (651) Northfield Cub Pharmacy # Highway 3 S Northfield,MN (507) Northfield Hospital Ed 2000 North Ave Northfield,MN (507) Rosemount Cub Pharmacy # Th St Rosemount,MN (651) Walgreens # Shannon Pkwy Rosemount,MN (952) Saint Paul Cub Pharmacy # Robert St S Saint Paul,MN (651) Kmart Pharmacy # Signal Hills Ctr Saint Paul,MN (651) Walgreens # Robert St S Saint Paul,MN (651) Walgreens # Pilot Knob Rd Saint Paul,MN (952) West Saint Paul CVS Pharmacy # Robert St S West Saint Paul,MN (651) Pace Pediatrics 1547 Livingston Ave West Saint Paul,MN (952) Target #T Robert St S West Saint Paul,MN (651) Wal*Mart Phcy # Robert St S West Saint Paul,MN (651) DODGE Kasson Kasson Drug Store 408 W Main St Kasson,MN (507) DOUGLAS Alexandria K Mart # Highway 29 S Alexandria,MN (320) Target #T Highway 29 S Alexandria,MN (320) Thrifty-White # Highway 29 S Alexandria,MN (320) Wal*Mart # Th Ave W Alexandria,MN (320) Walgreens # Broadway St Alexandria,MN (320) Osakis Thrifty White Drug # Central Ave Osakis,MN (320) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

47 MN Chain Pharmacies FARIBAULT Blue Earth Wal*Mart # Giant Dr Blue Earth,MN (507) FILLMORE Preston Haugan's Pharmacy 136 Main St SE Preston,MN (507) Spring Valley Valley Pharmacy 501 N Park Dr Spring Valley,MN (507) FREEBORN Albert Lea Hy-Vee Pharmacy # Bridge Ave Albert Lea,MN (507) Shopko Pharmacy # Bridge Ave Albert Lea,MN (507) Shopko Pharmacy # North Bridge Ave Albert Lea,MN (507) Wal*Mart Phcy # Blake Ave Albert Lea,MN (507) Walgreens # Bridge Ave Albert Lea,MN (507) GOODHUE Pine Island Pine Island Pharmacy 119 N Main St Pine Island,MN (507) Red Wing More 4 Family Phcy # Main St Red Wing,MN (651) Target #T Tyler Rd N Red Wing,MN (651) Thrifty-White # Potter St Red Wing,MN (651) Wal*Mart Phcy # Tyler Rd S Red Wing,MN (651) GRANT Ashby Thrifty White Pharmacy # Main St Ashby,MN (218) HENNEPIN Bloomington Cub Pharmacy # W 84Th St Bloomington,MN (952) Hlthpartners Bloomington 8600 Nicollet Ave S Bloomington,MN (952) Rainbow Pharmacy # W 80Th St Bloomington,MN (952) Sam's Pharmacy # W 79Th St Bloomington,MN (952) Target #T W 79Th St Bloomington,MN (952) Wal*Mart # W 78Th St Bloomington,MN (952) Walgreens # Portland Ave S Bloomington,MN (952) Walgreens # Lyndale Ave S # 101 Bloomington,MN (952) Walgreens # Penn Ave S Bloomington,MN (952) Brooklyn Center Cub Pharmacy # County Rd B Brooklyn Center,MN (763) Hlthpartners Brooklyn Ctr 6845 Lee Ave N Brooklyn Center,MN (763) Target #T Shingle Creek Pkwy Brooklyn Center,MN (763) Walgreens # Brooklyn Blvd Brooklyn Center,MN (763) Brooklyn Park Cub Pharmacy # W Broadway Ave Brooklyn Park,MN (763) Cub Pharmacy # Colorado Lane N Brooklyn Park,MN (763) Target #T W Broadway Ave Brooklyn Park,MN (763) Wal*Mart # Lakeland Ave N Brooklyn Park,MN (763) Walgreens # Th Ave N Brooklyn Park,MN (763) Walgreens # Brooklyn Blvd Brooklyn Park,MN (763) Champlin Cub Pharmacy # Th Ave N Champlin,MN (763) Target #T Business Park Blvd Champlin,MN (763) Walgreens # Market Place Rd Champlin,MN (763) Crystal Cub Pharmacy # Th Ave N Crystal,MN (763) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 47

48 Walgreens # Bass Lake Rd Crystal,MN (783) Eden Prairie Costco Pharmacy # Technology Dr Eden Prairie,MN (952) Cub Pharmacy # Den Rd Eden Prairie,MN (952) Health Partners 9700 W 76Th St Ste A Eden Prairie,MN (952) Target #T Flying Cloud Dr Eden Prairie,MN (952) Thrifty White Drug # Valley View Rd Eden Prairie,MN (952) Wal*Mart # Singletree Ln Eden Prairie,MN (952) Walgreens # Hennepin Town Rd Eden Prairie,MN (952) Walgreens # Eden Prairie Rd Eden Prairie,MN (952) Edina Cub Pharmacy # York Ave S Edina,MN (612) Prairie Stone # France Ave S Edina,MN (952) Prairie Stone # W 50Th St Edina,MN (952) Target #T York Ave S Edina,MN (952) Walgreens # France Ave S Edina,MN (952) Walgreens # York Ave S Edina,MN (612) Golden Valley Walgreens # Duluth St Golden Valley,MN (612) Hopkins Walgreens # Blake Rd N Hopkins,MN (952) Walgreens # Highway 7 Hopkins,MN (952) Maple Grove Costco Pharmacy # Fountains Dr N Maple Grove,MN (763) Cub Pharmacy # Wedgewood Ln N Maple Grove,MN (763) CVS Pharmacy # Wedgwood Rd Maple Grove,MN (763) Maple Grove Urgent Care Elm Creek Blvd #130 Maple Grove,MN (763) Prairie Stone # Elm Creek Blvd N Maple Grove,MN (763) Rainbow Pharmacy # County Road 30 Maple Grove,MN (763) Sams Pharmacy # Th Ave N Maple Grove,MN (763) Target #T Grove Cir N Maple Grove,MN (763) Wal*Mart Phcy # Dunkirk Ln N Maple Grove,MN (763) Walgreens # County Road 30 Maple Grove,MN (612) Walgreens # Grove Dr Maple Grove,MN (763) Medina Target #T Highway 55 Medina,MN (763) Minneapolis Abbott Northwestern Hosp 800 E 28Th St Minneapolis,MN (612) Cub Pharmacy # Th Ave S Minneapolis,MN (612) Cub Pharmacy # Nicollet Ave Minneapolis,MN (612) Cub Pharmacy # W Broadway Ave Minneapolis,MN (612) CVS Pharmacy # Brooklyn Blvd Minneapolis,MN (763) CVS Pharmacy # Central Ave NE Minneapolis,MN (612) CVS Pharmacy # Hennepin Ave Minneapolis,MN (612) CVS Pharmacy # W Broadway Ave Minneapolis,MN (612) CVS Pharmacy # Nicollet Ave Minneapolis,MN (612) Fairview Home Infusion 711 Kasota Ave SE Ste A Minneapolis,MN (612) Healthpartners Riverside 2220 Riverside Ave Minneapolis,MN (612) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

49 MN Chain Pharmacies K Mart # W Lake St Minneapolis,MN (612) Prairiestone # W 98Th St Minneapolis,MN (952) Prairiestone #18 55 University Ave SE Minneapolis,MN (612) Rainbow Pharmacy # Lagoon Ave Minneapolis,MN (612) Rainbow Pharmacy # New Brighton Blvd Minneapolis,MN (612) Statscript Phcy # Lyndale Ave S Minneapolis,MN (612) Target #T W Broadway Ave Minneapolis,MN (763) Target #T E Lake St Minneapolis,MN (612) Target #T New Brighton Blvd Minneapolis,MN (612) Target #T Nicollet Mall Minneapolis,MN (612) Walgreens # Vicksburg Ln N Minneapolis,MN (763) Walgreens # W Broadway Ave Minneapolis,MN (612) Walgreens # Chicago Ave Minneapolis,MN (612) Walgreens # E Lake St Minneapolis,MN (612) Walgreens # Central Ave NE Minneapolis,MN (612) Walgreens # W Lake St Minneapolis,MN (612) Walgreens # Nicollet Mall Minneapolis,MN (612) Walgreens # Lyndale Ave S Minneapolis,MN (612) Walgreens # Hennepin Ave Minneapolis,MN (612) Walgreens # Hiawatha Ave Minneapolis,MN (612) Walgreens # W Lake St Ste 200 Minneapolis,MN (612) Walgreens # W Lake St Minneapolis,MN (612) Minnetonka Cub Pharmacy # Highway 101 Minnetonka,MN (952) K Mart # Highway 7 Minnetonka,MN (952) Prairie Stone # Highway 7 Minnetonka,MN (952) Prairie Stone # Ridgedale Dr Minnetonka,MN (952) South Lake Pediatrics Hutchins Dr Ste 101 Minnetonka,MN (952) Target #T Ridgedale Dr Minnetonka,MN (612) Target #T County Road 101 Minnetonka,MN (952) Walgreens # Highway 101 Minnetonka,MN (952) Mound Thrifty-White # Commerce Blvd Mound,MN (952) New Hope CVS Pharmacy # Bass Lake Rd New Hope,MN (763) K Mart # Xylon Ave N New Hope,MN (763) Walgreens # Winnetka Ave N New Hope,MN (763) Plymouth Cub Pharmacy # Nathan Ln N Plymouth,MN (763) Cub Pharmacy # Vicksburg Ln N Plymouth,MN (763) CVS Pharmacy # County Road 101 N Plymouth,MN (763) Prairie Stone # Vicksburg Ln N Plymouth,MN (763) Rainbow Pharmacy # Th Ave N Plymouth,MN (763) Rainbow Pharmacy # County Road 24 Plymouth,MN (763) Target #T Vinewood Ln N Plymouth,MN (763) Walgreens # Vinewood Ln N Plymouth,MN (763) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 49

50 Richfield K Mart # Lyndale Ave S Richfield,MN (612) Prairie Stone # Penn Ave S Richfield,MN (612) Rainbow Pharmacy # W 66Th St Richfield,MN (612) Target #T Richfield Pkwy Richfield,MN (612) Walgreens # W 66Th St Richfield,MN (612) Robbinsdale CVS Pharmacy # Lakeland Ave N Robbinsdale,MN (763) N Memorial Medical Ctr 3300 Oakdale Ave N Robbinsdale,MN (763) Walgreens # W Broadway Ave Robbinsdale,MN (763) Rogers Target #T S Diamond Lake Rd Rogers,MN (763) Walgreens # St Ave N Rogers,MN (763) Saint Anthony Wal*Mart Phcy # Silver Lake Rd NE Saint Anthony,MN (612) Saint Louis Park Costco Pharmacy # W 16Th St Saint Louis Park,MN (763) Cub Pharmacy # Texas Ave S Saint Louis Park,MN (952) Healthpartners West 1533 Utica Ave S Saint Louis Park,MN (952) Sams Pharmacy # Louisiana Ave S Saint Louis Park,MN (952) Target #T Highway 100 S Saint Louis Park,MN (612) Shorewood Target #T Highway 7 St Louis Park,MN (952) Wayzata Prairie Stone # Wayzata Blvd E Wayzata,MN (952) HUBBARD Park Rapids Coborn's Pharmacy # St St W Park Rapids,MN (218) Pamida Pharmacy # East St. E Park Rapids,MN (218) St Joseph's Area Hlth Svs 600 Pleasant Ave S Park Rapids,MN (218) Wal*Mart Phcy # Charles St Park Rapids,MN (218) ISANTI Cambridge Cub Pharmacy # Xylite St NE Cambridge,MN (763) Walgreens # Garfield St S Cambridge,MN (763) ITASCA Grand Rapids Cub Pharmacy # S Pokegama Ave Grand Rapids,MN (218) K Mart # S Pokegama Ave Grand Rapids,MN (218) Target #T S Pokegama Ave Grand Rapids,MN (218) Thrifty-White # S Pokegama Ave Grand Rapids,MN (218) Wal*Mart # S Pokegama Ave Grand Rapids,MN (218) JACKSON Jackson Pamida Pharmacy # Nd St Jackson,MN (507) KANABEC MN Chain Pharmacies Cub Pharmacy # Rogers Dr Rogers,MN (763) CVS Pharmacy # Main St Rogers,MN (763) Cub Pharmacy # State Hwy 7 Shorewood,MN (952) St Louis Park Prairiestone # Park Center Blvd St Louis Park,MN (952) Target #T Balsam St N Ste 100 Cambridge,MN (763) Wal*Mart # Walmart Ln Cambridge,MN (763) Mora Coborn's Pharmacy # Frankie Ln Mora,MN (320) Pamida # Highway 65 S Mora,MN (320) This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

51 MN Chain Pharmacies Princeton Coborn's Pharmacy # Th Ave So. Princeton,MN (763) KANDIYOHI New London Cash Wise Clinic Phcy # Peterson Pkwy New London,MN (320) Spicer Cash Wise Pharmacy # Highway 23 Ste 4 Spicer,MN (320) Willmar Cashwise Pharmacy # Willmar Ave SW Willmar,MN (320) Cashwise Pharmacy # Th St SE Willmar,MN (320) Cub Pharmacy # St St S Willmar,MN (320) K Mart # St St S Willmar,MN (952) Rice Memorial Hospital 301 Becker Ave SW Willmar,MN (952) Target #T St St S Willmar,MN (320) Thrifty-White # St St S Willmar,MN (320) Wal*Mart # St St S Willmar,MN (320) KITTSON Karlstad Thrifty White Drug # Cleveland Ave E Karlstad,MN (218) KOOCHICHING Intl Falls Duluth Clinic Int Falls 2501 Keenan Dr Intl Falls,MN (218) Kmart # Highway 11 # 71 Intl Falls,MN (218) LAC QUI PARLE Madison Thrifty White Drug # Th Ave Madison,MN (320) LINCOLN Tyler Thrifty White Pharmacy # N Tyler St Tyler,MN (507) LYON Marshall Cashwise Clin Phcy # E College Dr Marshall,MN (507) Hy-Vee Pharmacy # E Main St Marshall,MN (507) K Mart # N Highway 23 Byp Marshall,MN (507) Shopko Pharmacy # Susan Dr Marshall,MN (507) Thrifty-White # W Main St Marshall,MN (507) Wal*Mart # E Main St Marshall,MN (507) MAHNOMEN Mahnomen Thrifty White Drug # N Main St Mahnomen,MN (218) MARTIN Fairmont K Mart # N State St Fairmont,MN (507) Wal*Mart Phcy # Goemann Rd Fairmont,MN (507) Walgreens # E Blue Ave Fairmont,MN (507) Sherburn Sherburn Clinic 32 N Main St Sherburn,MN (507) Truman Truman Clinic/Mayo Health Sys 401 North Ave E Truman,MN (507) MC LEOD Glencoe Coborn's Pharmacy # Th St E Glencoe,MN (320) Pamida # Th St E Glencoe,MN (320) Hutchinson Cashwise Pharmacy # Highway 15 S Hutchinson,MN (320) Econofoods Pharmacy 205 Washington Ave E Hutchinson,MN (320) Hutchinson Hospital Ed 1095 Highway 15 S Hutchinson,MN (320) Shopko Pharmacy # Main St N Hutchinson,MN (320) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 51

52 Target T Highway 15 Hutchinson,MN (320) Wal*Mart # Trunk Hwy 15 South Hutchinson,MN (320) Winsted Glencoe Regional Hlth Svcs 511 4Th St North Winsted,MN (952) MEEKER Litchfield Econo Food Pharmacy 951 E Frontage Rd Litchfield,MN (320) Pamida # E Frontage Rd Litchfield,MN (320) Wal*Mart Phcy # E Frontage Rd Litchfield,MN (320) MILLE LACS Milaca Thrifty White Pharmacy # Nd Ave SW Milaca,MN (320) Princeton Pamida # Northland Dr Princeton,MN (763) Thrifty White Pharmacy # Rum River Dr N Princeton,MN (763) MORRISON Little Falls Coborn's Pharmacy # Nd Ave NE Little Falls,MN (320) Wal*Mart # St Ave NE Little Falls,MN (320) MOWER Austin Hy-Vee Pharmacy # Th Ave NW Austin,MN (507) K Mart # Th Ave NW Austin,MN (507) Medicap Pharmacy # W Oakland Ave Austin,MN (507) Shopko Pharmacy # Th Ave NW Austin,MN (507) Target #T Th Ave NW Austin,MN (507) Wal*Mart Phcy # Th Ave NW Austin,MN (623) Walgreens # W Oakland Ave Austin,MN (507) NICOLLET Saint Peter More 4 Family Phcy # S Minnesota Ave Saint Peter,MN (507) NOBLES Worthington Shopko Pharmacy # N Humiston Ave Worthington,MN (507) Wal*Mart Phcy # Ryans Rd Worthington,MN (507) Walgreens # Oxford St Worthington,MN (507) NORMAN Ada Thrifty White Drug # Rd Ave W Ada,MN (218) OLMSTED Byron Byron Marketplace Pharmacy 863 High Point Dr NE Byron,MN (507) Chatfield Chosen Valley Pharmacy 237 Main St N Chatfield,MN (507) Rochester Cub Pharmacy # Th Ave SE Rochester,MN (507) Hy-Vee Pharmacy # Crossroads Dr Rochester,MN (507) Hy-Vee Pharmacy # Th St NW Rochester,MN (507) K Mart # Th St SE Rochester,MN (507) Sam's Pharmacy # Th St NW Rochester,MN (507) Shopko Pharmacy # Highway 63 S Rochester,MN (507) Shopko Pharmacy # Highway 63 N Rochester,MN (507) Target #T Marketplace Dr NW Rochester,MN (507) Target #T Maine Ave SE Rochester,MN (507) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

53 MN Chain Pharmacies Wal*Mart # Th St NW Rochester,MN (507) Wal*Mart Phcy # Th St SW Rochester,MN (507) Weber & Judd Barlow Plaza Th St NW Rochester,MN (507) Weber & Judd Clinic Phcy 210 9Th St SE Rochester,MN (507) Weber & Judd Nursing Care Th St NW Rochester,MN (507) Weber And Judd-Marriott Plaza 101 1St Ave SW Rochester,MN (507) OTTER TAIL Fergus Falls K Mart # W Lincoln Ave Fergus Falls,MN (218) Lake Region Healthcare 712 S Cascade St Fergus Falls,MN (218) Pamida # E Lincoln Ave Fergus Falls,MN (218) Sun Mart Pharmacy # W Lincoln Ave Fergus Falls,MN (218) Thrifty-White # E Lincoln Ave Fergus Falls,MN (218) Thrifty-White # S Mill St Fergus Falls,MN (218) Wal*Mart # Highway 210 W Fergus Falls,MN (218) Perham Pamida Pharmacy # Jake St SE Perham,MN (218) Thrifty White # St Ave S Perham,MN (218) PENNINGTON Thief River Falls Northwest Medical Center 120 Labree Ave S Thief River Falls,MN (952) Thrifty-White # Horace Ave N Thief River Falls,MN (218) Wal*Mart Phcy # Highway 59 S # 1755 Thief River Falls,MN (218) PINE Pine City Pamida # Evergreen Sq SW Pine City,MN (320) Wal*Mart # Hillside Ave Pine City,MN (320) PIPESTONE Pipestone Pamida # Th St SE Pipestone,MN (507) POLK Crookston Thrifty White Drug # W 2Nd St Crookston,MN (218) Thrifty-White # N Main St Crookston,MN (218) Wal*Mart Phcy # Sahlstrom Dr Crookston,MN (218) East Grand Forks Pamida # Gateway Dr NE East Grand Forks,MN (218) Fertile Thrifty White Drug # N Mill St Fertile,MN (218) POPE Glenwood Pamida Pharmacy # County Road 21 S Glenwood,MN (320) RAMSEY Arden Hills Cub Pharmacy # Lexington Ave N Arden Hills,MN (651) Hlthpartners Arden Hills 3920 Northwoods Dr Arden Hills,MN (651) Pharmacare Phcy # Pine Tree Dr Ste 290 Arden Hills,MN (651) Maplewood Cub Pharmacy # White Bear Ave N Maplewood,MN (651) Cub Pharmacy # County Road B W Maplewood,MN (651) Healthpartners Maplewood 2165 White Bear Ave N Maplewood,MN (651) Minnesota Cancer Care 1580 Beam Ave Maplewood,MN (651) Walgreens # White Bear Ave N Maplewood,MN (651) Walgreens # White Bear Ave N Maplewood,MN (651) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 53

54 Minneapolis Cub Pharmacy # Silver Lake Rd NE Minneapolis,MN (612) Walgreens # Silver Lake Rd NE Minneapolis,MN (612) Mounds View CVS Pharmacy # County Road 10 Mounds View,MN (763) Walgreens # Highway 10 Mounds View,MN (763) New Brighton Cub Pharmacy # Rice Creek Rd New Brighton,MN (651) North St Paul Target #T Highway 36 E North St Paul,MN (651) Roseville Cub Pharmacy # Snelling Ave N Roseville,MN (651) Target #T County Road B W Roseville,MN (651) Walgreens # Lexington Ave N Roseville,MN (651) Walgreens # County Road C W Roseville,MN (651) Walgreens # Rice St Roseville,MN (651) Saint Paul Aspen Medical Group 1850 Beam Ave Saint Paul,MN (952) Cub Pharmacy # University Ave W Saint Paul,MN (651) Cub Pharmacy # Meadowlands Dr Saint Paul,MN (651) Cub Pharmacy # Hudson Rd Saint Paul,MN (651) CVS Pharmacy # White Bear Ave N Saint Paul,MN (651) CVS Pharmacy # Grand Ave Saint Paul,MN (651) CVS Pharmacy # Snelling Ave N Saint Paul,MN (651) CVS Pharmacy # Maryland Ave E Saint Paul,MN (615) CVS Pharmacy # Highway 61 N Saint Paul,MN (651) Healthpartners Como 2500 Como Ave Saint Paul,MN (651) Healthpartners Specialty Ctr Phc 401 Phalen Blvd Saint Paul,MN (651) Healthpartners St Paul 205 Wabasha St S Saint Paul,MN (651) Hlthpartners Phys Clinic 451 Dunlap St N Saint Paul,MN (651) K Mart # Maryland Ave E Saint Paul,MN (651) Metro Urology 2550 University Ave W Saint Paul,MN (651) Prairie Stone # Grand Ave Saint Paul,MN (651) Prairie Stone # Ford Pkwy Saint Paul,MN (651) Prairiestone # Suburban Ave Saint Paul,MN (651) Rainbow Pharmacy # Arcade St Saint Paul,MN (651) Target #T Suburban Ave Saint Paul,MN (651) Target #T University Ave W Saint Paul,MN (651) United Family Physicians 545 7Th St W Saint Paul,MN (651) Wal*Mart Phcy # University Ave West Saint Paul,MN (651) Walgreens # Maryland Ave W Saint Paul,MN (651) Walgreens # Grand Ave Saint Paul,MN (651) Walgreens # University Ave W Saint Paul,MN (651) Walgreens # Highway 96 E Saint Paul,MN (651) Walgreens # Maryland Ave E Saint Paul,MN (651) Walgreens # Old Hudson Rd Saint Paul,MN (651) Walgreens # White Bear Ave N Saint Paul,MN (651) Walgreens # Randolph Ave Saint Paul,MN (651) Walgreens # Rice St Saint Paul,MN (651) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

55 MN Chain Pharmacies Walgreens # Arcade St Saint Paul,MN (651) Walgreens # Wabasha St N Saint Paul,MN (651) Shoreview Target #T Lexington Ave N Shoreview,MN (651) Vadnais Heights Target #T East County Rd E Vadnais Heights,MN (651) Wal*Mart # County Road E E Vadnais Heights,MN (651) White Bear Lake CVS Pharmacy # County Road E E White Bear Lake,MN (651) Healthpartners White Bear 1430 Highway 96 E White Bear Lake,MN (651) K Mart # White Bear Ave N White Bear Lake,MN (651) Sams Pharmacy # Buerkle Rd White Bear Lake,MN (651) RED LAKE Red Lake Falls Thrifty White Drug # International Dr Red Lake Falls,MN (218) REDWOOD Redwood Falls Wal*Mart # E Bridge St Redwood Falls,MN (507) RENVILLE Renville Thrifty White Phcy # N Main St Renville,MN (320) RICE Dundas K Mart #3777 South Highway #3 Dundas,MN (507) Faribault Hy-Vee Pharmacy # Grant St NW Faribault,MN (507) Wal*Mart # Western Ave NW Faribault,MN (507) Walgreens # Th St NW Faribault,MN (507) Northfield More 4 Family Phcy # Division St S Northfield,MN (507) Walgreens #09065 Hwy 3 & 6Th Northfield,MN (507) ROCK Luverne Lewis Family Drug # S Spring St Luverne,MN (507) Pamida # W Interstate Dr Luverne,MN (507) ROSEAU Roseau Pamida Pharmacy # Rd St NW Roseau,MN (218) SAINT LOUIS Duluth Aic Pharmacy 420 E 1St St Duluth,MN (218) Cub Pharmacy # W Central Entrance Duluth,MN (218) Duluth Clinic 1St St Pharmacy 420 E 1St St Duluth,MN (218) Duluth Clinic Pharmacy 400 E 3Rd St Duluth,MN (218) K Mart # Mall Dr Duluth,MN (218) K Mart # N Central Ave Duluth,MN (218) Lakeside Clinic Pharmacy 4619 E Superior St Duluth,MN (218) Shopko Pharmacy # W Central Entrance Duluth,MN (218) Target #T Highway 53 Duluth,MN (218) Walgreens # E Superior St Duluth,MN (218) Walgreens # Grand Ave Duluth,MN (218) Walgreens # Miller Trunk Hwy Duluth,MN (218) West Duluth Clinic Pharmacy 4212 Grand Ave Duluth,MN (218) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 55

56 Ely Pamida Pharmacy # E Chapman St Ely,MN (218) Hermantown Dc-Hermantown Pharmacy 4855 W Arrowhead Rd Hermantown,MN (218) Sams Pharmacy # Maple Grove Rd Hermantown,MN (218) Wal*Mart # Mall Dr Hermantown,MN (218) Hibbing Dc-Hibbing Pharmacy 730 E 34Th St Hibbing,MN (218) Thrifty White Drug # E 37Th St Hibbing,MN (218) Thrifty-White # E Howard St Hibbing,MN (218) Wal*Mart Phcy # Highway 169 W Hibbing,MN (218) Walgreens # E 37Th St Hibbing,MN (218) Mountain Iron Walgreens # Mountain Iron Dr Mountain Iron,MN (218) Virginia Duluth Clinic Va Pharmacy Th St N Virginia,MN (218) K Mart # S 12Th Ave Virginia,MN (218) Target #T Th St S Virginia,MN (218) White Drug # Chestnut St Virginia,MN (218) SCOTT New Prague Coborn's Pharmacy # Alton Ave SE New Prague,MN (952) Queen of Peace Hospital 301 2Nd St NE New Prague,MN (952) Prior Lake Crossroads Medical Center Commerce Ave NE Prior Lake,MN (952) Savage Cub Pharmacy # Highway 13 S Savage,MN (952) Rainbow Pharmacy # Highway 13 S Savage,MN (952) Target #T Hwy 13 Savage,MN (952) Walgreens # W County Road 42 Savage,MN (952) Shakopee Crossroads Medical Center Th Ave E Ste 2 Shakopee,MN (952) Cub Pharmacy # Vierling Ct Shakopee,MN (952) CVS Pharmacy # Dean Lakes Blvd Shakopee,MN (952) Sam's Pharmacy # Old Carriage Court Shakopee,MN (952) Target #T Th Ave East Shakopee,MN (952) Wal*Mart Phcy # Old Carriage Court Shakopee,MN (952) Walgreens # Tasha Dr Shakopee,MN (952) Shukopee St Francis Medical Center 1455 T Francis Ave Shukopee,MN (952) SHERBURNE Big Lake Coborn's Pharmacy # Rose Dr Big Lake,MN (763) Elk River Coborn's Pharmacy # Evans St NW Elk River,MN (763) Cub Pharmacy # Freeport St Elk River,MN (763) Dr Gene Winkelman Business Center Dr NW Elk River,MN (763) Target #T Freeport St Elk River,MN (763) Wal*Mart Phcy # Vane St Elk River,MN (763) Walgreens # Carson Ct Elk River,MN (763) St Cloud Cub Pharmacy # Th St NE St Cloud,MN (320) STEARNS Clearwater Coborn's Pharmacy #8 705 County Road Clearwater,MN (320) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

57 MN Chain Pharmacies Collegeville Collegeville Phcy # St Raphael's Hall Collegeville,MN (320) Saint Cloud Coborn's 5Th Avenue # Cooper Ave S Saint Cloud,MN (320) Coborn's Ltc Phcy # Ridgewood Rd Ste 1 Saint Cloud,MN (320) Coborn's Pharmacy # Th St N Saint Cloud,MN (320) Cub Pharmacy # Rd Ave S Saint Cloud,MN (320) Shopko Pharmacy # Nd St S Saint Cloud,MN (320) Target #T W Division St Saint Cloud,MN (320) Wal*Mart # Rd Ave S Saint Cloud,MN (320) Walgreens # W Division St Saint Cloud,MN (320) Sartell Coborn's Pharmacy # Pine Cone Rd S Sartell,MN (320) Coborn's Pharmacy # St Ave N Sartell,MN (320) Walgreens # Nd St S Sartell,MN (320) Sauk Centre Coborn's Pharmacy # Th St S Sauk Centre,MN (320) Wal*Mart Phcy # Th St S Sauk Centre,MN (320) Waite Park Cashwise Pharmacy #9 113 Waite Ave S Waite Park,MN (320) K Mart # Nd St S Waite Park,MN (320) STEELE Owatonna Cashwise Pharmacy # W North St Owatonna,MN (507) Owatonna Hospital 903 S Oak Ave Owatonna,MN (952) Target #T Park Dr Owatonna,MN (507) Wal*Mart # Hoffman Dr Owatonna,MN (507) Walgreens # Th St SE Owatonna,MN (507) STEVENS Morris Pamida # E Highway 28 Morris,MN (320) Thrifty White Drug # Atlantic Ave Morris,MN (320) Thrifty White Drug # Atlantic Ave Morris,MN (320) TODD Long Prairie Coborn's Pharmacy # Lake St S Long Prairie,MN (320) WADENA Wadena Pamida Pharmacy # Jefferson St N Wadena,MN (218) Wal*Mart Phcy # Juniper Ave Wadena,MN (218) WASECA Waseca Hy-Vee Pharmacy # N State St Waseca,MN (507) Thirfty-White # E Elm Ave Waseca,MN (507) Wal*Mart # N State St Waseca,MN (507) Waseca Hospital Ed 501 N State St Waseca,MN (507) WASHINGTON Cottage Grove Cub Pharmacy # E Point Douglas Rd S Cottage Grove,MN (651) Target #T E Point Douglas Rd S Cottage Grove,MN (651) Walgreens # E Point Douglas Rd S Cottage Grove,MN (651) Forest Lake Target #T Th St SW Forest Lake,MN (651) Wal*Mart # Th St SW Forest Lake,MN (952) Walgreens # W Broadway Ave Forest Lake,MN (651) Oak Park Hts Wal*Mart # Norell Ave N Oak Park Hts,MN (651) This pharmacy does not offer extended supplies of maintenance medications. MINNESOTA 57

58 Oakdale K Mart # Th St N Oakdale,MN (505) Rainbow Pharmacy # Th St N Oakdale,MN (651) Target #T Nd St N Oakdale,MN (651) Walgreens # Geneva Ave N Oakdale,MN (651) Park Heights Walgreens # Osgood Ave N Park Heights,MN (651) Saint Paul CVS Pharmacy # Eagle Creek Ln Saint Paul,MN (651) Wal*Mart Phcy # Hudson Rd Saint Paul,MN (651) Stillwater Cub Pharmacy # Market Dr Stillwater,MN (651) Target #T Market Dr Stillwater,MN (651) White Bear Lake Walgreens # Wildwood Rd White Bear Lake,MN (651) Woodbury Cub Pharmacy # Tamarack Vlg Woodbury,MN (651) Healthpartners Woodbury 8450 Seasons Pkwy Woodbury,MN (651) Target #T Valley Creek Plz Woodbury,MN (651) Walgreens # Valley Creek Plz Woodbury,MN (651) Walgreens # Donegal Dr Woodbury,MN (651) WATONWAN Saint James Pamida Pharmacy # St Ave S Saint James,MN (507) WINONA Saint Charles Brownwell Drug 401 W 4Th St Saint Charles,MN (507) Winona Econo Family Phcy # Service Dr Winona,MN (507) Hy-Vee Pharmacy # Service Dr Winona,MN (507) K Mart # W Highway 61 Winona,MN (507) Shopko Pharmacy # Cottonwood Dr Winona,MN (507) Target #T Mankato Ave Winona,MN (507) Wal*Mart Phcy # Frontenac Dr Winona,MN (507) Walgreens # Mankato Ave Winona,MN (507) WRIGHT Albertville Coborn's Pharmacy # Lacentre Ave NE Albertville,MN (763) Buffalo Buffalo Hospital Ed 303 Catlin St Buffalo,MN (763) Cub Pharmacy # Highway 55 E Buffalo,MN (763) Target #T Highway 55 E Buffalo,MN (763) Wal*Mart # Highway 25 N Buffalo,MN (763) Delano Coborn's Pharmacy # Babcock Blvd E Delano,MN (763) CVS Pharmacy # Babcock Blvd E Delano,MN (763) Monticello Big Lake Community Hosp 1013 Hart Blvd Monticello,MN (763) Cub Pharmacy # Th St W Monticello,MN (763) K Mart # Th St W Monticello,MN (763) Target #T E 7Th St Monticello,MN (763) Wal*Mart Phcy # Cedar St Monticello,MN (763) Saint Michael Thrifty White Drug # Main St S Saint Michael,MN (763) YELLOW MEDICINE Granite Falls Thrifty White Drug # Prentice St Granite Falls,MN (320) MN Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications MINNESOTA

59 Mail Order Pharmacies MINNESOTA 59

60 Mail-Order Pharmacies Mail-Order Pharmacies Medco By Mail Contact the Medco By Mail Customer Service department using the contact information on the front cover. TTY/TDD users should call Liberty Medical TTY/TDD users should call MINNESOTA

61 Home Infusion Pharmacies This plan will cover home infusion therapy if: Your prescription drug is on the plan s formulary or you have a formulary exception. The Plan has approved your prescription drug for home infusion therapy. Your prescription is written by an authorized prescriber. Home infusion pharmacies specialize in the preparation of medications that are administered intravenously or by injection. To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. MINNESOTA 61

62 MINNESOTA Accredo Therapeutics Inc 2915 Waters Rd Ste 109 Eagan,MN (651) Alternative Infusion Services Th St S Ste 101 Saint Cloud,MN (320) Apria Pharmacy-Minnetonka 131 Cheshire Ln Ste 500 Hopkins,MN (800) Coagulife Pharmacy 8690 Eagle Creek Pkwy Savage,MN (952) Coram Altemate Site Services Inc 2901 S Frontage Rd Ste 7 Moorhead,MN (218) Coram Alternate Site Svcs 2345 Waters Dr Mendota Hts,MN (651) Fairview Home Infusion 711 Kasota Ave SE Ste A Minneapolis,MN (612) Option Care 1000 S Benton Dr Ste 405 Sauk Rapids,MN (320) Option Care Enterprises Inc 2750 Arthur St Roseville,MN (651) Pediatric Home Respiratory Servi 2800 Cleveland Ave N Roseville,MN (651) Trumm Drug Parkers Prairie 114 E Soo St Parkers Prairie,MN (218) MN Home Infusion Pharmacies Geritom Med Pharmacy 1631 E 79Th St Ste 142 Bloomington,MN (952) Heartland Home Healthcare 1752 Terrace Dr Roseville,MN (651) Mapleton Drug 404 Main St E Mapleton,MN (507) MINNESOTA

63 Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under the Plan through the facility s longterm care pharmacy or another network long-term care pharmacy. A long-term care pharmacy provides medications to residents of long-term care facilities (such as nursing homes and residential care facilities, mental health facilities, hospices, and long-term care or skilled nursing care beds in hospitals). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. MINNESOTA 63

64 MINNESOTA Arensons Snyder Drug 43 Oak Ave N Annandale,MN (320) Arrow Assisted Living Pharmacy 109 N 2Nd Ave W Ste 200 Duluth,MN (218) B E Drug Inc 405 S Grove St Blue Earth,MN (507) Bloomington Drug 509 W 98Th St Bloomington,MN (952) Boyes Clinic Pharmacy 301 Central Ave N Faribault,MN (507) City Center Drug Hardware 117 Front St S # 399 Barnesville,MN (218) Clenwood Corner Drug Inc 1 Minnesota Ave E Glenwood,MN (651) Cook Hospital Pharmacy 10 5Th St SE Cook,MN (218) Corner Drugs 204 Valley Green Sq Le Sueur,MN (651) Country Manor Ltc Pharmacy 520 1St St NE Ste A Sartell,MN (320) Falk's Nursing Service 221 E 14Th St Duluth,MN (218) Family Rexall Drug Inc 237 Hassan St SE Hutchinson,MN (320) Genoa Healthcare Minnesota LLC 1821 University Ave W # N464 Saint Paul,MN (651) Geritom Med Pharmacy 1631 E 79Th St Ste 142 Bloomington,MN (952) Goltz Pharmacy 274 E 3Rd St Winona,MN (507) Health One Pharmacy 414 Gateway Blvd Burnsville,MN (952) Holder Snyder Drug 124 Minnesota Ave N Aitkin,MN (218) Hunt Silver Lake Drug 1510 N Broadway Rochester,MN (507) Hy-Vee Pharmacy # Grant St NW Faribault,MN (507) Hy-Vee Pharmacy # Adams St Mankato,MN (507) Hy-Vee Pharmacy # E Main St Marshall,MN (507) Hy-Vee Pharmacy # Service Dr Winona,MN (507) Isanti Drug 23 W Main St Isanti,MN Lakes Snyder Drug 808 Lake St S Forest Lake,MN (651) Lifecare Pharmacy /2 Pl N Minneapolis,MN Lindstrom Snyder Drug Lincoln Rd Lindstrom,MN (651) Main Street Pharmacy 24 3Rd St NE Osseo,MN (763) Main Street Pharmacy 370 S Main St Zumbrota,MN (507) Mapleton Drug 404 Main St E Mapleton,MN (507) Med Save Family Pharmacy 217 Paul Buryan Dr NW Bemidji,MN (218) Medical Pharmacy Moorhead Th St S Moorhead,MN (218) Merwin Ltc Pharmacy # Th Ave S Apt 16 Minneapolis,MN (612) Merwin Ltc Pharmacy # Rd St SW New Brighton,MN (651) Merwin Ltc Pharmacy #3 133 Main St S Ste 2 Cambridge,MN (763) Mille Lacs Hospital Pharmacy 200 Elm St N Onamia,MN (320) Nystrom Thrifty Drug 223 S 8Th St Brainerd,MN (218) Nystrom Thrifty Drug # Th St S Brainerd,MN (218) Pamida # E Frontage Rd Litchfield,MN (320) Pamida # E Highway 28 Morris,MN (320) Pamida # Gateway Dr NE East Grand Forks,MN (218) Pamida # Southgate Dr Aitkin,MN (218) Pamida # Paul Bunyan Dr S Bemidji,MN (218) MN Long-Term Care Pharmacies MINNESOTA

65 MN Long-Term Care Pharmacies Pamida # E Lincoln Ave Fergus Falls,MN (218) Pamida # Northland Dr Princeton,MN (763) Pamida # Highway 65 S Mora,MN (320) Pamida # St Ave N Windom,MN (507) Pamida # Th St E Glencoe,MN (320) Pamida # W Interstate Dr Luverne,MN (507) Pamida # Th St SE Pipestone,MN (507) Pamida Pharmacy # St Ave S Saint James,MN (507) Pamida Pharmacy # Rd St NW Roseau,MN (218) Pamida Pharmacy # East St. E Park Rapids,MN (218) Pamida Pharmacy # County Road 21 S Glenwood,MN (320) Pamida Pharmacy # E Chapman St Ely,MN (218) Paynesville Corner Drug 122 Washburne Ave Paynesville,MN (320) Pelican Drug 11 N Broadway Pelican Rapids,MN (218) Peters Snyder Drug 321 Jefferson St N Wadena,MN (218) Pharmerica # E River Rd Ste 201 Fridley,MN (763) Pipestone County Medical Center 916 4Th Ave SW Pipestone,MN (507) Preferred Choice Phcy Inc 900 Long Lake Rd Ste 150 New Brighton,MN (651) Prescription Center St St S Willmar,MN (320) Ramsey Pharmacy 5300 Alpine Dr NW Ramsey,MN (763) Randy's Family Drug 121 1St Ave S Sleepy Eye,MN (507) Range Drug Inc 20 W Main St Crosby,MN (218) Red Wing Corner Drug 401 W 3Rd St Red Wing,MN (651) Rogers Drug John Milless Dr Rogers,MN Scofield Drugs & Gifts 108 4Th St N Cannon Falls,MN (507) Snyder Drug 802 8Th Ave SE Pipestone,MN (507) Snyder Drug Store 126 5Th St N Breckenridge,MN (218) St Therese Pharmacy 8000 Bass Lake Rd New Hope,MN (612) Sterling Long Term Nd St SE Owatonna,MN (507) The Medicine Shoppe # Broadway St Ste 100 Alexandria,MN (320) The Medicine Shoppe # Th Ave Worthington,MN (507) The Medicine Shoppe # St St S Willmar,MN (320) The Medicine Shoppe # Jefferson St N Wadena,MN (218) The Medicine Shoppe # E Highway 12 Litchfield,MN (320) The Medicine Shoppe # Central Ave Long Prairie,MN (320) The Medicine Shoppe # Robert St S Saint Paul,MN (651) Thirfty-White # E Elm Ave Waseca,MN (507) Thomson Snyder Drug 408 Lake St NE Warroad,MN (218) Thrifty White # St Ave S Perham,MN (218) Thrifty White # S Marshall Ave Springfield,MN (507) Thrifty White Drug # Cleveland Ave E Karlstad,MN (218) Thrifty White Drug # International Dr Red Lake Falls,MN (218) MINNESOTA 65

66 Thrifty White Drug # E 37Th St Hibbing,MN (218) Thrifty White Drug # Atlantic Ave Morris,MN (320) Thrifty White Drug # Main St S Saint Michael,MN (763) Thrifty White Drug # Central Ave Osakis,MN (320) Thrifty White Drug # North Main Bagley,MN (218) Thrifty White Drug # Main St Clearbrook,MN (218) Thrifty White Drug # Minnesota Ave W Walker,MN (218) Thrifty White Drug # Michigan Ave W Walker,MN (218) Thrifty White Drug # Nd St Lake Park,MN (218) Thrifty White Drug # Arrowhead Ln Moose Lake,MN (218) Thrifty White Drug # Th Ave Madison,MN (320) Thrifty White Drug # Atlantic Ave Morris,MN (320) Thrifty White Drug # Rd Ave W Ada,MN (218) Thrifty White Drug # Prentice St Granite Falls,MN (320) Thrifty-White # St St S Willmar,MN (320) Thrifty-White # Highway 29 S Alexandria,MN (320) Thrifty-White # W Main St Marshall,MN (507) Thrifty-White # Potter St Red Wing,MN (651) Thrifty-White # S Pokegama Ave Grand Rapids,MN (218) Thrifty-White # N Main St Crookston,MN (218) Thrifty-White # Paul Bunyan Dr NW Bemidji,MN (218) Thrifty-White # E Lincoln Ave Fergus Falls,MN (218) Thrifty-White # S Mill St Fergus Falls,MN (218) Thrifty-White # Horace Ave N Thief River Falls,MN (218) Village Pharmacy & Gift 108 2Nd Ave S Sauk Rapids,MN (320) Virginia Regional Medical 901 9Th St N Virginia,MN (218) Wahl Drug 403 6Th St Hawley,MN (218) Watertown Pharmacy 204 Lewis Ave S Ste 101 Watertown,MN (952) White Drug # Washington Ave Detroit Lakes,MN (218) White Drug # Chestnut St Virginia,MN (218) White Mart #0107 Pinetree Plaza Mall Cloquet,MN (218) Witt's Pharmacy-Ltc 213 S Mill St Rushford,MN (507) MN Long-Term Care Pharmacies Thrifty White Drug # N Mill St Fertile,MN (218) Thrifty-White # Commerce Blvd Mound,MN (952) Throndset Pharmacy Co 326 Main St Lakefield,MN (507) Wolff Drug 207 Main St Pierz,MN (320) Thrifty White Drug # W 2Nd St Crookston,MN (218) Thrifty-White # Vermillion St Hastings,MN (651) United Phcy Associates 5534 Lakeland Ave N Minneapolis,MN (763) Wolff's Mushel Drug 101 1St St SE Little Falls,MN (320) Thrifty White Drug # N Main St Mahnomen,MN (218) Thrifty-White # E Howard St Hibbing,MN (218) Unity Family Healthcare Pharmacy 815 2Nd St SE Little Falls,MN (320) Wolfs Wayzata Pharmacy 1310 Wayzata Blvd E Wayzata,MN (952) MINNESOTA

67 Indian Health Service/Tribal/ Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through the plan s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. MINNESOTA 67

68 MINNESOTA Bois Forte Band Nett Lake Rd Nett Lake,MN (201) Cass Lake Hospital 317 7Th St NW Cass Lake,MN (218) Fond Du Lac Cair Pharmacy 211 W 4Th St Duluth,MN (218) Min No Aya Win Clinic Phy 927 Trettel Ln Cloquet,MN (218) Red Lake Ihs Pharmacy PO Box 160 Redlake,MN (218) White Earth Health Center Cty Hwy Ogema,MN MN I/T/U Pharmacies MINNESOTA

69 MONTANA

70

71 Retail Pharmacies MONTANA 71

72 MONTANA BIG HORN Crow Agency Crow Pharmacy 212 Hwy & 1-90 Intersection Crow Agency,MT (406) Lodge Grass Lodge Grass Pharmacy Harding Ave Lodge Grass,MT (406) Pryor Pryor Pharmacy PO Box 9 Pryor,MT (406) BLAINE Harlem Fort Belknap Pharmacy 456 Gros Ventre Ave Harlem,MT (406) Hays Hays Health Center Pharmacy 123 White Cow Rd Hays,MT (406) CASCADE Great Falls Kindred Pharmacy Services Nd St S Great Falls,MT (406) Spectrum Pharmacy Th Ave S Great Falls,MT (406) DAWSON Glendive F & G Pharmacy 107 N Merrill Ave Glendive,MT (406) DEER LODGE Warm Springs McKesson Medication Mgmt LLC 202 Garnet Way Warm Springs,MT (406) FLATHEAD Columbia Falls Montana State Veterans Home 400 Veterans Dr Columbia Falls,MT (406) Kalispell At Home Solutions Inc 175 Commons Loop Ste 400 Kalispell,MT (406) Kalispell Regional Medical Ctr P 310 Sunnyview Ln Kalispell,MT (406) GALLATIN Belgrade Lee & Dad's Pharmacy 205 Madison Ave Belgrade,MT (406) Bozeman At Home Solutions Inc Pinewood Profess Ctr Ste 1 Bozeman,MT (406) Price Rite # N 7Th Ave Bozeman,MT (406) GLACIER Browning Blackfeet Pharmacy 760 Hospital Circle Browning,MT (406) Heart Butte Heart Butte Pharmacy 81 Disney Heart Butte,MT (406) HILL Havre Northern Montana Hospital Pharma 30 13Th St Havre,MT (406) Northern Montana Pharmacy 20 13Th St Havre,MT (406) JEFFERSON Whitehall Whitehall Drug 29 W Legion Whitehall,MT (406) LAKE Polson Healthcare Plus 1 7Th Ave E Polson,MT (406) Ronan Family Health Pharmacy 225 Hwy 93 South Ronan,MT (406) Saint Ignatius Confederated Salish & Kootenai T PO Box 880 Saint Ignatius,MT (406) LEWIS AND CLARK Helena South Hills Pharmacy 2600 Winne Ave Helena,MT (406) LINCOLN Libby Franks 293-Drug Pc 1401 Minnesota Ave Libby,MT (406) Troy Kootenai Drug 611 E. Missoula Ave. Troy,MT (406) MADISON Ennis Ennis Pharmacy 125 Main St Ennis,MT (406) MISSOULA Lolo Lolo Drug 103 Glacier Dr Lolo,MT (406) MT Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 72 MONTANA 153

73 MT Retail Pharmacies Missoula A & C Rexall Drug 523 N Higgins Ave Missoula,MT (406) Hillside Manor Pharmacy Rd Ave Missoula,MT (406) Savmor # S 3Rd St W Ste 100 Missoula,MT (406) Village Health Care Center Rd Ave Ste 200 Missoula,MT (406) PARK Gardiner Gardiner Pharmacy 208 Park St Gardiner,MT (406) Livingston Western Drug of 1313 W Park St Livingston,MT (406) Sidney Clinic Pharmacy Th Ave SW Sidney,MT (406) Sidney Health Center Pharmacy Th Ave SE Sidney,MT (406) ROOSEVELT Culbertson Culbertson Pharmacy 115 Broadway Culbertson,MT (406) Poplar Poplar Pharmacy 107 H Street H Poplar,MT (406) Wolf Point Wolf Point Pharmacy 550 6Th Ave N Wolf Point,MT (406) ROSEBUD Lame Deer YELLOWSTONE Billings At Home Solutions Inc 404 N 31St St Fl 4 Billings,MT (406) Billings Health & Rehabi Communi 2115 Central Ave Billings,MT (406) Pharmacy 1 Ltc Th Ave N Ste 110-B Billings,MT (406) Saint Johns Pharmacy 3940 Rimrock Rd Billings,MT (406) Valley Healthcare Center Th St W Billings,MT (406) Laurel Price Pharmacy 18 1St Ave Laurel,MT (406) RAVALLI Hamilton Timber Ridge Pharmacy 1131 N 1St St Hamilton,MT (406) RICHLAND Fairview Mondak Clinic Pharmacy 304 South Ellery Fairview,MT (406) Lame Deer Health Center Pharmacy 100 Cheyenne Ave Lame Deer,MT (406) TREASURE Forsyth Yellowstone Pharmacy 1025 Main St Forsyth,MT (406) This pharmacy does not offer extended supplies of maintenance medications. MONTANA 73

74 Chain Pharmacies 74 MONTANA

75 MONTANA BEAVERHEAD Dillon Pamida Pharmacy # E Glendale St Dillon,MT (406) Safeway Pharmacy # E Helena St Dillon,MT (406) CASCADE Great Falls Albertsons/Osco Pharmacy # Rd St NW Great Falls,MT (406) Albertsons/Osco Pharmacy # Th Ave S Great Falls,MT (406) CVS Pharmacy # Th Ave S Great Falls,MT (406) K Mart # Rd St NW Great Falls,MT (406) Pharmerica # Central Ave W Ste 105 Great Falls,MT (406) Shopko Pharmacy # Northwest Byp Great Falls,MT (406) Smiths Pharmacy # Market Place Dr Great Falls,MT (406) Wal*Mart # Smelter Ave NE Great Falls,MT (406) Wal*Mart Phcy # Northwest Byp Great Falls,MT (406) Walgreens # Th Ave S Great Falls,MT (406) Walgreens # Rd St NW Great Falls,MT (406) CUSTER Miles City Albertsons/Osco Pharmacy # S Haynes Ave Miles City,MT (406) Wal*Mart # Stower St Miles City,MT (406) DAWSON Glendive Albertsons/Osco Pharmacy # Harmon St Glendive,MT (406) DEER LODGE Anaconda CVS Pharmacy # E Park Ave Anaconda,MT (406) Safeway Pharmacy #0256 Park Street & Larch St Anaconda,MT (406) FERGUS Lewistown Albertsons/Osco Pharmacy # W Janeaux St Lewistown,MT (406) Pamida Pharmacy # NE Main St Lewistown,MT (406) FLATHEAD Columbia Falls Pamida Pharmacy # St Ave W Columbia Falls,MT (406) Smiths Pharmacy # Nucleus Ave Columbia Falls,MT (406) Kalispell Albertsons/Osco Pharmacy # W Idaho St Kalispell,MT (406) Costco Pharmacy # US Highway 93 N Kalispell,MT (406) K Mart # La Salle Road Kalispell,MT (509) Shopko Pharmacy # US Highway 2 E Kalispell,MT (406) Smiths Pharmacy # Rd Ave NE Kalispell,MT (406) Wal*Mart # E Idaho St Kalispell,MT (406) Walgreens # W Idaho St Kalispell,MT (406) Whitefish Safeway Pharmacy # US Highway 93 S Whitefish,MT (406) GALLATIN Belgrade Albertsons/Osco Pharmacy # Jackrabbit Ln Belgrade,MT (406) Bozeman Albertsons/Osco Pharmacy # S 23Rd Ave Bozeman,MT (406) Costco # Catron Rd Bozeman,MT (602) MT Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 847 MONTANA 75

76 MT Chain Pharmacies CVS Pharmacy # W Main St Bozeman,MT (406) K Mart # N 7Th Ave Bozeman,MT (406) Safeway Pharmacy # W Main St Bozeman,MT (406) Smiths Pharmacy # N 19Th Ave Bozeman,MT (406) Wal*Mart # N 7Th Ave Bozeman,MT (406) GLACIER Cut Bank Albertsons/Osco Pharmacy # W Main St Cut Bank,MT (406) HILL Havre K Mart # US Highway 2 W Havre,MT (406) Wal*Mart Phcy # US Highway 2 W Havre,MT (406) LAKE Polson Safeway Pharmacy # Nd Ave E Polson,MT (406) Wal*Mart # Heritage Ln Polson,MT (406) LEWIS AND CLARK Helena Costco Pharmacy # E Custer Ave Helena,MT (406) CVS Pharmacy # N Montana Ave Helena,MT (406) CVS Pharmacy # Euclid Ave Helena,MT (406) K Mart # Cedar St Helena,MT (406) Safeway Pharmacy # N Montana Ave Helena,MT (406) Shopko Pharmacy # N Montana Ave Helena,MT (406) Wal*Mart # Prospect Ave Helena,MT (406) MISSOULA Missoula Albertsons/Osco Pharmacy # S Russell St Missoula,MT (406) Albertsons/Osco Pharmacy # Oxford St Missoula,MT (406) Albertsons/Osco Pharmacy # N Reserve St Missoula,MT (406) Costco # Northern Pacific Ave Missoula,MT (406) CVS Pharmacy # Brooks St Missoula,MT (406) Kmart # Brooks St Missoula,MT (406) Safeway Pharmacy # W Broadway St Missoula,MT (406) Safeway Pharmacy # S Reserve St Missoula,MT (406) Shopko Pharmacy # S Reserve St Missoula,MT (406) Target #T N Reserve St Missoula,MT (406) Wal*Mart # Old US Highway 93 S Missoula,MT (406) Wal*Mart Phcy # Mullah Rd Missoula,MT (406) Walgreens # N Reserve St Missoula,MT (406) Walgreens # Brooks St Missoula,MT (406) MUSSELSHELL Roundup Pamida Pharmacy # Main St Roundup,MT (406) PARK Livingston Albertsons/Osco Pharmacy # Highway 89 S Livingston,MT (406) Pamida # Washington St Livingston,MT (406) This pharmacy does not offer extended supplies of maintenance medications. 76 MONTANA

77 POWELL Deer Lodge Safeway Pharmacy # N Main St Deer Lodge,MT (406) RAVALLI Hamilton Albertsons/Osco Pharmacy # N 1St St Hamilton,MT (406) Walgreens # N 1St St Hamilton,MT (406) RICHLAND Sidney Pamida Pharmacy # S Central Ave Sidney,MT (406) White Drug # E Main St Sidney,MT (406) SILVER BOW Butte CVS Pharmacy # Harrison Ave Butte,MT (406) K Mart # Harrison Ave Butte,MT (406) Safeway Pharmacy # Block Mass Avenue Butte,MT (406) Wal*Mart # Harrison Ave Butte,MT (406) SWEET GRASS Big Timber Pamida Pharmacy # McLeod Big Timber,MT (406) TOOLE Shelby Pamida # Roosevelt Hwy Shelby,MT (406) VALLEY Glasgow Pamida Pharmacy # US Highway 2 W Glasgow,MT (406) YELLOWSTONE Billings Albertsons/Osco Pharmacy # N 27Th St Billings,MT (406) Albertsons/Osco Pharmacy # Main St Billings,MT (406) Albertsons/Osco Pharmacy # Central Ave Billings,MT (406) Albertsons/Osco Pharmacy # Grand Ave Billings,MT (406) Albertsons/Osco Pharmacy # Grand Ave Billings,MT (406) Albertsons/Osco Pharmacy # Central Ave Billings,MT (406) Costco # King Ave W Billings,MT (406) CVS Pharmacy # Grand Ave Billings,MT (406) CVS Pharmacy # Grand Ave Billings,MT (406) CVS Pharmacy # Main St Billings,MT (406) CVS Pharmacy # N 27Th St Billings,MT (406) K Mart # Central Ave Billings,MT (406) NCS Healthcare of Mt Inc 1611 Alderson Ave Billings,MT (406) Shopko Pharmacy # S 24Th St W Billings,MT (406) Target #T Central Ave Billings,MT (406) Wal*Mart # King Ave W Billings,MT (406) Wal*Mart Phcy # Main St Billings,MT (406) Walgreens # Main St Billings,MT (406) Walgrlens # Grand Ave Billings,MT (406) Laurel CVS Pharmacy # SE 4Th St Laurel,MT (406) Wal*Mart Phcy # Bernhardt Rd Laurel,MT (406) MT Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 849 MONTANA 77

78 Mail Order Pharmacies 78 MONTANA

79 Mail-Order Pharmacies Medco By Mail Contact the Medco By Mail Customer Service department using the contact information on the front cover. TTY/TDD users should call Liberty Medical TTY/TDD users should call Mail-Order Pharmacies 1327 MONTANA 79

80 Home Infusion Pharmacies This plan will cover home infusion therapy if: Your prescription drug is on the plan s formulary or you have a formulary exception. The Plan has approved your prescription drug for home infusion therapy. Your prescription is written by an authorized prescriber. Home infusion pharmacies specialize in the preparation of medications that are administered intravenously or by injection. To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 80 MONTANA

81 MONTANA At Home Solutions Inc Pinewood Profess Ctr Ste 1 Bozeman,MT (406) At Home Solutions Inc Transwestern 1 Bldg #401 Billings,MT (406) At Home Solutions Inc 175 Commons Loop Ste 400 Kalispell,MT (406) Choteau Drug Inc 102 Main Ave N Choteau,MT (406) Haines Drug 998 US Highway 93 N Eureka,MT (406) MT Home Infusion Pharmacies 1381 MONTANA 81

82 Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under the Plan through the facility s longterm care pharmacy or another network long-term care pharmacy. A long-term care pharmacy provides medications to residents of long-term care facilities (such as nursing homes and residential care facilities, mental health facilities, hospices, and long-term care or skilled nursing care beds in hospitals). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 82 MONTANA

83 MONTANA Castle Mtn Drug 25 E Main St White Sulphur Springs,MT (406) Columbus Iga Pharmacy 133 W 5Th Ave N Columbus,MT (406) East Gate Drug 1003 E Broadway St Missoula,MT (406) Franks Express Drug Pc 1401 Minnesota Ave Libby,MT (406) Haines Drug 148 Central Ave Whitefish,MT (406) Haines Drug 998 US Highway 93 N Eureka,MT (406) Healthcare Plus 1 7Th Ave E Polson,MT (406) Highland Park Pharmacy 925 Highland Blvd Bozeman,MT (406) Hillside Manor Pharmacy Rd Ave Missoula,MT (406) Kalispell Regional Medical Ctr P 310 Sunnyview Ln Kalispell,MT (406) Keystone Drug Llp 407 Main St Deer Lodge,MT (406) Kindred Pharmacy Services Nd St S Great Falls,MT (406) Lee & Dad's Pharmacy 205 Madison Ave Belgrade,MT (406) McKesson Medication Mgmt LLC 1 Pharmacy Rd Warm Springs,MT (406) Montana State Veterans Home 400 Veterans Dr Columbia Falls,MT (406) NCS Healthcare of Mt Inc 1611 Alderson Ave Billings,MT (406) Northern Montana Hospital Pharma 30 13Th St Havre,MT (406) Pamida # Roosevelt Hwy Shelby,MT (406) Pamida Pharmacy # S Central Ave Sidney,MT (406) Pharmacy # Th Ave N Ste 101W Billings,MT (406) Pharmacy 1 Ltc Th Ave N Ste 110-B Billings,MT (406) Pharmerica # Central Ave W Ste 105 Great Falls,MT (406) Ridgeway Pharmacy Ltd 39 Stevensville Cut-Off Stevensville,MT (406) Riverside Health Care Pharmacy 1301 E Broadway St Missoula,MT Sidney Health Center Pharmacy Th Ave SE Sidney,MT (406) South Hills Pharmacy 2600 Winne Ave Helena,MT (406) Spectrum Pharmacy Th Ave S Great Falls,MT (406) Stoick Drug LLC 142 E Idaho St Kalispell,MT (406) Sykes Pharmacy Inc 202 2Nd Ave W Kalispell,MT (406) Townsend Drug 308 Broadway St Townsend,MT (406) Valley Drug of Malta Inc 131 S 1St Ave E Malta,MT (406) Valley Healthcare Center Th St W Billings,MT (406) Village Drug 608 S Main St Conrad,MT (406) Village Health Care Center Rd Ave Ste 200 Missoula,MT (406) Western Drug of 1313 W Park St Livingston,MT (406) White Drug # E Main St Sidney,MT (406) Yellowstone Pharmacy 1025 Main St Forsyth,MT (406) MT Long-Term Care Pharmacies 1499 MONTANA 83

84 Indian Health Service/Tribal/ Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through the plan s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 84 MONTANA

85 MONTANA Blackfeet Pharmacy 760 Hospital Circle Browning,MT (406) Confederated Salish & Kootenai T PO Box 880 Saint Ignatius,MT (406) Crow Pharmacy 212 Hwy & 1-90 Intersection Crow Agency,MT (406) Fort Belknap Pharmacy 456 Gros Ventre Ave Harlem,MT (406) Hays Health Center Pharmacy 123 White Cow Rd Hays,MT (406) Heart Butte Pharmacy 81 Disney Heart Butte,MT (406) Lame Deer Health Center Pharmacy 100 Cheyenne Ave Lame Deer,MT (406) Poplar Pharmacy 107 H Street H Poplar,MT (406) Pryor Pharmacy PO Box 9 Pryor,MT (406) Wolf Point Pharmacy 550 6Th Ave N Wolf Point,MT (406) MT I/T/U Pharmacies Lodge Grass Pharmacy Harding Ave Lodge Grass,MT (406) MONTANA 85

86

87 NEBRASKA

88

89 Retail Pharmacies NEBRASKA 89

90 ADAMS Hastings NEBRASKA Nebraska Cancer Care 815 N Kansas Ave Ste 100 Hastings,NE (402) Village Pharmacy Inc 300 S 1St Ave Hastings,NE (402) BOONE Albion Good Life Pharmacy Albion 124 S 4Th St Albion,NE (402) Saint Edward Marshall Pharmacy 307 Beaver St Saint Edward,NE (402) BOYD Spencer Spencer Pharmacy 211 N Thayer St Spencer,NE (402) BUFFALO Kearney Haeberles Grand Central 7 W 25Th St Kearney,NE (308) CHASE Imperial Hometown Healthmart Pharmacy 1324 Broadway Imperial,NE (308) CHEYENNE Sidney Wilson & Tobin Drug Store 1000 Illinois St Ste 571 Sidney,NE (308) CUSTER Broken Bow Varney Health Mart 744 S E St Broken Bow,NE (308) DAKOTA South Sioux City Redler's Long Term Care 1010 W 29Th St Ste 214 South Sioux City,NE (402) DAWSON Cozad Service Drug 133 E 8Th St Cozad,NE (308) DODGE Fremont Famcare Pharmacy 450 E 23Rd St Fremont,NE (402) Miller Pharmacy Specialties 1900 E Military Ave Fremont,NE (402) DOUGLAS Elkhorn Community Pharmacy Services Veterans Dr Elkhorn,NE (402) Omaha Ed's Rexall 2701 S 10Th St Omaha,NE (402) Gerimed Pharmacy 7915 N 30Th St Omaha,NE (402) Heartland Ltc Pharmacy Q St Omaha,NE (402) Heartland Md Pharmacy Services Q St Omaha,NE (402) Infuscience 8710 F St Ste 118 Omaha,NE (402) Medicap Pharmacy # S 108Th St Omaha,NE (402) Medwell Rx Q St Omaha,NE (402) Option Care Enterprises Inc John Galt Blvd Omaha,NE (402) Pharmerica # S 118Th St Omaha,NE (888) The Nebraska Med Center Clinic P Nebraska Medical Omaha,NE (402) Vna Home Infusion Therapy Compan 1941 S 42Nd St Ste 225 Omaha,NE (402) Valley Valley Ltc Pharmacy Inc 123 1/2 E Gardiner St Valley,NE (402) Valley Pharmacy 123 E Gardiner St Valley,NE (402) DUNDY Benkelman Benkelman Pharmacy 509 Chief St Benkelman,NE (308) FILLMORE Geneva Family Health Services 1325 H St Geneva,NE (402) NE Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 90 NEBRASKA 167

91 NE FRANKLIN JEFFERSON LANCASTER PHELPS Franklin Fairbury Lincoln Holdrege Retail Pharmacies Naden's Pharmacy 1312 Q St Franklin,NE (308) GAGE Beatrice The Medicine Shoppe # Court St Beatrice,NE (402) HALL Grand Island Midwest Ltc Pharmacy 3003 Frontage Rd Ste 2 Grand Island,NE (308) Option Care Enterprises Inc 2545 W Lincoln Hwy Ste 2 Grand Island,NE (308) HOLT Bassett Rock Country Clinic 801 South State Street Bassett,NE (402) HOWARD Saint Paul Brehm Drug Inc 608 Howard Ave Saint Paul,NE (308) Swinarski Pharmacy 624 Howard Ave Saint Paul,NE (308) Jefferson Community Health Cente 2200 H St Fairbury,NE (402) KIMBALL Kimball Bemis Drug Inc 121 E 2Nd St Kimball,NE (308) Walker Pharmacy 129 S Chestnut St Kimball,NE (308) KNOX Bloomfield Bloomfield Pharmacy 102 N Broadway Bloomfield,NE (402) Creighton Manions Health Mart 719 Main Street Creighton,NE (402) Verdigre Verdigre Pharmacy 403 James Street Verdigre,NE (402) Wausa Creutz Drug Store 517 E Broadway St # F Wausa,NE (402) Bryan Plaza Pharmacy 1500 S 48Th St Lincoln,NE (402) Extendcare The Pharmacy 1221 N Cotner Blvd Ste 3 Lincoln,NE (402) National Ltc Pharmacy 6891 A St Ste 105 Lincoln,NE (402) Option Care Enterprises Inc 4401 S 70Th St Ste 2 Lincoln,NE (402) Wagey Drug 800 N 27Th St Lincoln,NE (402) NEMAHA Auburn Family Value Pharmacy Th St Ste 201 Auburn,NE (402) NUCKOLLS Superior Menke Drug Store 348 N Central Ave Superior,NE (402) OTOE Syracuse Town & Country Pharmacy 448 5Th St # 220 Syracuse,NE (402) Holdrege Pharmacy 516 W 14Th Ave Holdrege,NE (308) PIERCE Plainview Plainview Pharmacy 103 S Main St Plainview,NE (402) PLATTE Columbus Tooley Clinic Pharmacy Th St Columbus,NE (402) Tooley Drug Co Th St Columbus,NE (402) POLK Osceola Bailey Drug 260 N State St Osceola,NE (402) RED WILLOW Mc Cook Farrell's Drug 120 W B St Mc Cook,NE (308) McCook Pharmacy & Medical 205 Norris Ave Mc Cook,NE (308) This pharmacy does not offer extended supplies of maintenance medications. NEBRASKA 91

92 SARPY Bellevue Unmc Summit Plaza Phcy 3604 Summit Plaza Dr Bellevue,NE (402) Omaha Unidose Pharmacy S 152Nd St Ste B Omaha,NE (402) SCOTTS BLUFF Scottsbluff The Apothecary Shoppe 3911 Aveune B Ste M200 Scottsbluff,NE (308) SEWARD Seward Mueri Drug 530 Seward St Seward,NE (402) SHERMAN Loup City Goodlife Discount Phcy 707 O St Loup City,NE (308) THAYER Hebron Tchs Pharmacy 120 Park Ave Hebron,NE (402) THURSTON Macy Carl T Curtis Pharmacy 100 Indian Hill Dr Macy,NE (402) Winnebago Native Plains Pharmacy 701 Buffalo Trail Winnebago,NE (402) Winnebago Ihs Hospital Phcy PO Box Hh Winnebago,NE (402) VALLEY Ord Good Life Discount Phcy 125 S 16Th St Ord,NE (308) Good Life Long Term Care 127 S 16Th St Ord,NE (308) WASHINGTON Blair Barr Pharmacy 1651 Washington St Blair,NE (402) YORK Henderson Henderson Pharmacy 1060 N. Main Street Henderson,NE (402) NE Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications NEBRASKA

93 Chain Pharmacies NEBRASKA 93

94 ADAMS Hastings NEBRASKA Sun Mart Pharmacy # S Burlington Ave Hastings,NE (402) Wal*Mart # N Old Hwy 281 Hastings,NE (402) Walgreens # N Burlington Ave Hastings,NE (402) BOX BUTTE Alliance Pamida # Flack Ave Alliance,NE (308) BROWN Ainsworth Pamida Pharmacy # E 4Th Ainsworth,NE (402) BUFFALO Kearney K Mart # Nd Ave Kearney,NE (308) Medicap Pharmacy # Nd Ave Ste A Kearney,NE (308) Target #T Rd Road Ave Kearney,NE (308) Wal*Mart # Nd Ave Kearney,NE (308) Walgreens # Nd Ave Kearney,NE (308) CASS Plattsmouth Pamida # S 23Rd St Plattsmouth,NE (402) CHERRY Valentine Pamida Pharmacy # N Main St Valentine,NE (402) CHEYENNE Sidney Safeway Pharmacy # Illinois St Sidney,NE (308) Wal*Mart Phcy # Silverberg Dr Sidney,NE (308) CUMING West Point Pamida Pharmacy # Main St West Point,NE (402) CUSTER Broken Bow Pamida Pharmacy # S C St Broken Bow,NE (308) DAKOTA South Sioux City Hy-Vee Pharmacy # Dakota Ave South Sioux City,NE (402) Wal*Mart # Cornhusker Dr South Sioux City,NE (402) Walgreens # W 21St St South Sioux City,NE (402) DAWES Chadron Safeway Pharmacy # Morehead St Chadron,NE (308) Wal*Mart # Linden St Chadron,NE (308) DAWSON Gothenburg Pamida Pharmacy # Th St Gothenburg,NE (308) Lexington Wal*Mart # S Bridge St Lexington,NE (308) DODGE Fremont Food 4 Less # N Bell St Fremont,NE (402) Hy-Vee Pharmacy # E 23Rd St Fremont,NE (402) Wal*Mart # E 23Rd St Fremont,NE (402) Walgreens # E 23Rd St Fremont,NE (402) DOUGLAS Lavista Walgreens # Harrison St Lavista,NE (402) Omaha Accredo Therapeutics Inc P St Ste 118&119 Omaha,NE (402) Bakers Pharmacy # N 72Nd St Omaha,NE (402) Bakers Pharmacy # W Center Rd Omaha,NE (402) Baker's Supermarkets # N 90Th St Omaha,NE (402) NE Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 94 NEBRASKA 885

95 NE Chain Pharmacies Baker's Supermarkets # S 136Th St Omaha,NE (402) Baker's Supermarkets # W Maple Rd Omaha,NE (402) Baker's Supermarkets # N 30Th St Omaha,NE (402) Baker's Supermarkets # S Saddle Creek Rd Omaha,NE (402) Baker's Supermarkets # Lakeside Hills Plz Omaha,NE (402) Baker's Supermarkets # N 155Th Plz Omaha,NE (402) Costco Pharmacy # W Dodge Rd Omaha,NE (402) Drug Town # N 30Th St Omaha,NE (402) Hy-Vee Pharmacy #1 (1465) 5150 Center St Omaha,NE (402) Hy-Vee Pharmacy #10(1474) 3410 N 156Th St Omaha,NE (402) Hy-Vee Pharmacy #2 (1466) 3405 Oak View Dr Omaha,NE (402) Hy-Vee Pharmacy #3 (1469) 8809 W Center Rd Omaha,NE (402) Hy-Vee Pharmacy #4 (1467) Fort St Omaha,NE (402) Hy-Vee Pharmacy #5 (1470) 7910 Cass St Omaha,NE (402) Hy-Vee Pharmacy #6 (1535) 9707 Q St Omaha,NE (402) Hy-Vee Pharmacy #7 (1468) 3505 L St Omaha,NE (402) Hy-Vee Pharmacy #8 (1471) 747 N 132Nd St Omaha,NE (402) Hy-Vee Pharmacy #9 (1472) Welch Plaza Omaha,NE (402) K Mart # L St Omaha,NE (402) K Mart # S 144Th St Omaha,NE (402) K Mart # W Maple Rd Omaha,NE (402) Keystone Pharmacy # Maple St Omaha,NE (402) Kohll's Drug 5110 L St Omaha,NE (402) Kohll's Drug 2723 Leavenworth St Omaha,NE (402) Kohll's Drug & Homecare 2915 Leavenworth St Omaha,NE (402) Kohll's Millard Pharmacy Q St Omaha,NE (402) Kohll's Pacific Pharmacy 617 N 114Th St Omaha,NE (402) Kohll's Park Avenue Q St Omaha,NE (402) Kohll's Pharmacy & Homecare 5000 Dodge St Omaha,NE (402) Kohll's Westgate Pharmacy 84Th St Omaha,NE (402) No Frills Phcy Express # Q St Omaha,NE (402) No Frills Phcy Express # N 30Th St Omaha,NE (402) No Frills Phcy Xpress # S 24Th St Omaha,NE (402) No Frills Quality Care Phcy # S 50Th St Omaha,NE (402) Sam's Pharmacy # L St Omaha,NE (402) Shopko Pharmacy # S 84Th St Omaha,NE (402) Shopko Pharmacy # N 90Th St Omaha,NE (402) Shopko Pharmacy # W Center Rd Omaha,NE (402) Target #T N 132Nd St Omaha,NE (402) Target #T W Center Rd Omaha,NE (402) Target #T N 72Nd St Omaha,NE (402) Target #T Dodge St Omaha,NE (402) Target #T Evans Plaza Omaha,NE (402) Target #T K Plz Omaha,NE (402) This pharmacy does not offer extended supplies of maintenance medications. NEBRASKA 95

96 Wal*Mart Phcy # N 99Th St Omaha,NE (402) Wal*Mart Phcy # Wright St Omaha,NE (402) Wal*Mart Phcy # W Maple Rd Omaha,NE (402) Wal*Mart Phcy # L St Omaha,NE (402) Walgreens # S 136Th St Omaha,NE (402) Walgreens # Ames Ave Omaha,NE (402) Walgreens # R Plaza Omaha,NE (402) Walgreens # NW Radial Hwy Omaha,NE (402) Walgreens # N 132Nd St Omaha,NE (402) Walgreens # N 30Th St Omaha,NE (402) Walgreens # Blondo St Omaha,NE (402) Walgreens # W Center Rd Omaha,NE (402) Walgreens # Lake St Omaha,NE (402) Walgreens # Center St Omaha,NE (402) Walgreens # Fort St Omaha,NE (402) Walgreens # Cass St Omaha,NE (402) Walgreens # L St Omaha,NE (402) Walgreens # S 155Th St Omaha,NE (402) Walgreens # Dodge St Omaha,NE (402) Walgreens # S 171St St Omaha,NE (402) Walgreens # Spaulding Plaza Omaha,NE (402) Walgreens # S 24Th St Omaha,NE (402) Walgreens # W Center Rd Omaha,NE (402) Walgreens # W Dodge Rd Omaha,NE (402) Walgreens # N Saddle Creek Rd Omaha,NE (402) Walgreens # N 90Th St Omaha,NE (402) Walgreens # Burke St Omaha,NE (402) Walgreens # Manderson St Omaha,NE (402) Walgreens # N 72Nd St Omaha,NE (402) Papillion No Frills Quality Care Phcy # N Washington St Papillion,NE (402) Target #T N Washington St Papillion,NE (402) GAGE Beatrice Pamida Pharmacy # N 24Th St Beatrice,NE (402) Wal*Mart Phcy # N 6Th St Beatrice,NE (402) HALL Grand Island Hy-Vee Pharmacy # Wilmar Ave Grand Island,NE (308) K Mart # W 13Th St Grand Island,NE (308) Shopko Pharmacy # N Webb Rd Grand Island,NE (308) Wal*Mart # W 13Th St Grand Island,NE (308) Wal*Mart Phcy # S Locust St Grand Island,NE (308) Walgreens # W 2Nd St Grand Island,NE (308) HOLT Oneill Pamida Pharmacy # E Highway 20 Oneill,NE (402) JEFFERSON Fairbury Wal*Mart # K St Fairbury,NE (402) NE Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications NEBRASKA

97 NE Chain Pharmacies KEITH Ogallala Pamida # Texas Trail Dr Ogallala,NE (308) Safeway Pharmacy # N Spruce St Ogallala,NE (308) LANCASTER Lincoln CVS Pharmacy # S 48Th St Lincoln,NE (402) CVS Pharmacy # Superior St Lincoln,NE (402) CVS Pharmacy # S 56Th St Lincoln,NE (402) CVS Pharmacy # B N 66Th St Lincoln,NE (402) Hy-Vee Pharmacy #2 (1386) 2343 N 48Th St Lincoln,NE (402) Hy-Vee Pharmacy #3 (1387) 5020 N 27Th St Lincoln,NE (402) Hy-Vee Pharmacy #4 (1388) 6001 Village Dr Lincoln,NE (402) Hy-Vee Pharmacy #5 (1390) 7151 Stacy Ln Lincoln,NE (402) Medicap Pharmacy # Kensington Dr Lincoln,NE (402) Sams Pharmacy # N 27Th St Lincoln,NE (402) Shopko Pharmacy # S 27Th St Lincoln,NE (402) Shopko Pharmacy # S 66Th St Lincoln,NE (402) Shopko Pharmacy # N 27Th St Lincoln,NE (402) Shopko Pharmacy # S 27Th St Lincoln,NE (402) Sun Mart Pharmacy # W O St Lincoln,NE (402) Target #T N 48Th St Lincoln,NE (402) Target #T S 40Th St Lincoln,NE (402) Wal*Mart # N 27Th St Lincoln,NE (402) Wal*Mart Phcy # Andermatt Dr Lincoln,NE (402) Walgreens # Northem Lights Dr Lincoln,NE (402) Walgreens # South St Lincoln,NE (402) Walgreens # Village Dr Lincoln,NE (402) Walgreens # O St Lincoln,NE (402) Walgreens # N 48Th St Lincoln,NE (402) Walgreens # Superior St Lincoln,NE (402) Walgreens # N 27Th St Lincoln,NE (402) Walgreens # Pine Lake Rd Lincoln,NE (402) Walgreens # S 70Th St Lincoln,NE (402) Walgreens # W O St Lincoln,NE (402) Walgreens # Red Rock Ln Lincoln,NE (402) Walgreens # O St Lincoln,NE (402) Walgreens # S 48Th St Lincoln,NE (402) LINCOLN North Platte Shopko Pharmacy # E Philip Ave North Platte,NE (308) Wal*Mart # S Dewey St North Platte,NE (308) MADISON Norfolk Hy-Vee Pharmacy #1 (1460) 120 E Norfolk Ave Norfolk,NE (402) Hy-Vee Pharmacy #2 (1461) 2107 Taylor Ave Norfolk,NE (402) Shopko Pharmacy # Krenzien Dr Norfolk,NE (402) Wal*Mart # Pasewalk Ave Norfolk,NE (402) This pharmacy does not offer extended supplies of maintenance medications. NEBRASKA 97

98 Walgreens # Norfolk Ave Norfolk,NE (402) NEMAHA Auburn Pamida Pharmacy # Dahlke Ave Auburn,NE (402) NUCKOLLS Superior Pamida Pharmacy #155 Hwy 8 & Noren St Superior,NE (402) OTOE Nebraska City Pamida Pharmacy # S 11Th St Nebraska City,NE (402) Wal*Mart Phcy # S 11Th St Nebraska City,NE (402) PHELPS Holdrege Pamida Pharmacy # Burlington St Holdrege,NE (308) PLATTE Columbus Hy-Vee Pharmacy # Rd Ave Columbus,NE (402) Wal*Mart # Rd St Columbus,NE (402) Walgreens # St St Columbus,NE (402) RED WILLOW Mc Cook Wal*Mart # W B St Mc Cook,NE (308) RICHARDSON Falls City Pamida # Stone St Falls City,NE (402) SALINE Crete Pamida Pharmacy # Main Ave Crete,NE (402) Wal*Mart Phcy # E 29Th St Crete,NE (402) SARPY Bellevue Baker Pharmacy # Galvin Rd S Bellevue,NE (402) Bakers Pharmacy # Twin Creek Dr Bellevue,NE (402) Shopko Pharmacy # Galvin Rd S Bellevue,NE (402) Target #T Twin Creek Dr Bellevue,NE (402) Wal*Mart Phcy # S 15Th St Bellevue,NE (402) Walgreens # Galvin Rd S Bellevue,NE (402) Walgreens # S 36Th St Bellevue,NE (402) Lavista Baker's Supermarkets # S 84Th St Lavista,NE (402) Wal*Mart # S 83Rd St Lavista,NE (402) Omaha Bag N Save Phcy Express Harrison St Omaha,NE (402) Papillion Hy-Vee Pharmacy # S 73Rd St Papillion,NE (402) Kohll's Drug South Washington St Papillion,NE (402) SCOTTS BLUFF Scottsbluff Albertsons/Sav-On Phcy # Avenue B Scottsbluff,NE (308) Family Thrift Center Phcy 2817 Avenue B Scottsbluff,NE (308) K Mart # E 27Th St Scottsbluff,NE (308) Safeway Pharmacy # Broadway Scottsbluff,NE (308) Wal*Mart Phcy # Avenue I Scottsbluff,NE (308) Walgreens # W 27Th St Scottsbluff,NE (308) SEWARD Seward Wal*Mart # South St Seward,NE (402) WASHINGTON Blair Pamida # N 1St St Blair,NE (402) NE Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications NEBRASKA

99 NE WAYNE Wayne Pamida Pharmacy # Dearborn St Wayne,NE (402) YORK York Pamida Pharmacy # S Lincoln Ave York,NE (402) Wal*Mart # E Nobes Rd York,NE (402) Chain Pharmacies Walgreens # S Lincoln Ave York,NE (402) This pharmacy does not offer extended supplies of maintenance medications. NEBRASKA 99

100 Mail Order Pharmacies 100 NEBRASKA

101 Mail-Order Pharmacies Medco By Mail Contact the Medco By Mail Customer Service department using the contact information on the front cover. TTY/TDD users should call Liberty Medical TTY/TDD users should call Mail-Order Pharmacies 1327 NEBRASKA 101

102 Home Infusion Pharmacies This plan will cover home infusion therapy if: Your prescription drug is on the plan s formulary or you have a formulary exception. The Plan has approved your prescription drug for home infusion therapy. Your prescription is written by an authorized prescriber. Home infusion pharmacies specialize in the preparation of medications that are administered intravenously or by injection. To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 102 NEBRASKA

103 NEBRASKA Accredo Therapeutics Inc P St Ste 118&119 Omaha,NE (402) Barr Pharmacy 1651 Washington St Blair,NE (402) Elmwood Pharmacy 808 S 52Nd St Omaha,NE (402) Firstchoice Healthcare 8710 F St Ste 118 Omaha,NE (402) Lt Pedley Drug 419 N Colorado Ave Minden,NE (308) Miller Pharmacy Inc 1900 E Military Ave Fremont,NE (402) Option Care Enterprises Inc 4401 S 70Th St Ste 2 Lincoln,NE (402) Option Care Enterprises Inc John Galt Blvd Omaha,NE (402) Option Care Enterprises Inc 2545 W Lincoln Hwy Ste 2 Grand Island,NE (308) Seward Family Medical 250 N Columbia Ave Seward,NE (402) Vna Home Infusion Therapy Compan 1941 S 42Nd St Ste 225 Omaha,NE (402) NE Home Infusion Pharmacies 1387 NEBRASKA 103

104 Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under the Plan through the facility s longterm care pharmacy or another network long-term care pharmacy. A long-term care pharmacy provides medications to residents of long-term care facilities (such as nursing homes and residential care facilities, mental health facilities, hospices, and long-term care or skilled nursing care beds in hospitals). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 104 NEBRASKA

105 NEBRASKA A B C Drug Co 2202 Central Ave Kearney,NE (308) Alegent Health Lakeside Lakeside Hills Plz Omaha,NE (402) Arapahoe Pharmacy 507 Nebraska Avenue Arapahoe,NE (308) Barr Pharmacy 1651 Washington St Blair,NE (402) Beatrice Community Hospital 1110 N 10Th St Beatrice,NE (402) Bens Ltc Pharmacy 121 W 3Rd St Grand Island,NE (308) Bergan Mercy Med Bldg 7710 Mercy Rd Ste 110 Omaha,NE (402) Bloomfield Pharmacy 102 N Broadway Bloomfield,NE (402) Brehm Drug Inc 608 Howard Ave Saint Paul,NE (308) Buenz Drug Company 23 N Spruce St Ogallala,NE (308) Coleman Clinic Pharmacy 735 W 10Th St Wahoo,NE Community Pharmacy Services Veterans Dr Elkhorn,NE (402) Coop Plaza Pharmacy 401 S Beltline Hwy W Scottsbluff,NE (308) Corner Drug 301 N Oakland Ave Oakland,NE (402) Creutz Drug Store 517 E Broadway St Wausa,NE (402) Dailey's Clinic Pharmacy 964 N Laurel St Wahoo,NE Dave's U Save Pharmacy Jct Hwy 83 & Hwy 6 & 34 Mccook,NE (800) David City Discount Phcy 422 5Th St David City,NE (402) Extendcare The Pharmacy 1221 N Cotner Blvd Ste 3 Lincoln,NE (402) Family Value Pharmacy Th St Ste 201 Auburn,NE (402) Farrell's Drug 120 W B St Mc Cook,NE (308) Gerimed Pharmacy 7915 N 30Th St Omaha,NE (402) Good Life Long Term Care 127 S 16Th St Ord,NE (308) Grant Pharmacy Inc 218 Central Street Grant,NE (308) Hayes Pharmacy 706 West Main Alma,NE (308) Henderson Pharmacy 1310 Elm St Henderson,NE (402) Hofmann Pharmacy Inc 103 E 2Nd St Tilden,NE (402) Holcomb Pharmacy 421 S 9Th Ave Broken Bow,NE (308) Home Prescription Services Q St Omaha,NE Kens Pharmacy 1302 Linden Ave Crete,NE (888) Lloyd's Drug Mart 2600 Norfolk Ave Norfolk,NE (402) Lloyd's Pharmacy 2600 W Norfolk Ave Ste 100 Norfolk,NE Lt Pedley Drug 419 N Colorado Ave Minden,NE (308) Manions Health Mart 719 Main Street Creighton,NE (402) Mark's Pharmacy 624 Patterson St Cambridge,NE (308) McCook Pharmacy & Medical 205 Norris Ave Mc Cook,NE (308) McKinney's Pharmacy 215 Enterprise Dr Gretna,NE (402) Medi Save Pharmacy 2029 Lincoln Ave York,NE (800) Medicap Pharmacy # Fremont St Lincoln,NE Medicap Pharmacy # Nd Ave Ste A Kearney,NE (308) Menke Drug Store 348 N Central Ave Superior,NE (402) Mike's U Save Pharmacy 1317 Hill St Holdrege,NE (800) Milford Valu Rite Phcy 610 1St St Milford,NE (402) NE Long-Term Care Pharmacies 1505 NEBRASKA 105

106 NE Miller Pharmacy Specialties 1900 E Military Ave Fremont,NE (402) Pamida Pharmacy # Main Ave Crete,NE (402) Redler's Long Term Care 1010 W 29Th St Ste 214 South Sioux City,NE (402) Town & Country Pharmacy 448 5Th St # 220 Syracuse,NE (402) National Ltc Pharmacy 6891 A St Ste 105 Lincoln,NE (402) Pamida Pharmacy # S C St Broken Bow,NE (308) Right Drug 113 E Kimball St Callaway,NE (308) Unidose Pharmacy S 152Nd St Ste B Omaha,NE (402) Nebraska Long Term Care LLC 910 Court St Ste D Beatrice,NE Pamida Pharmacy # Main St West Point,NE (402) Ruffner Pharmacy 506 Chicago Ave Plattsmouth,NE (402) Valley Ltc Pharmacy Inc 123 1/2 E Gardiner St Valley,NE (402) Long-Term Care Pharmacies Pac N Save Discount Phcy 1519 W Highway 34 Ste 1 Seward,NE (402) Pamida # Stone St Falls City,NE (402) Pamida # S 23Rd St Plattsmouth,NE (402) Pamida # N 1St St Blair,NE (402) Pamida # Texas Trail Dr Ogallala,NE (308) Pamida # Flack Ave Alliance,NE (308) Pamida Pharmacy #155 Hwy 8 & Noren St Superior,NE (402) Pamida Pharmacy # Dearborn St Wayne,NE (402) Pamida Pharmacy # E Highway 20 Oneill,NE (402) Pamida Pharmacy # S 11Th St Nebraska City,NE (402) Pamida Pharmacy # Burlington St Holdrege,NE (308) Pamida Pharmacy # Dahlke Ave Auburn,NE (402) Pharmerica # S 118Th St Omaha,NE (888) Plainview Pharmacy 103 S Main St Plainview,NE (402) Priefert Pharmacy 428 Lincoln Ave Hebron,NE (402) Quantum Med Ltc Pharmacy 8807 F St Omaha,NE (402) Seward Family Medical 250 N Columbia Ave Seward,NE (402) Shopko Pharmacy # E Philip Ave North Platte,NE (308) Sixth Street Pharmacy 6Th And Lincoln St Lexington,NE (800) Tchs Pharmacy 120 Park Ave Hebron,NE (402) The Drug Store 201 Highway 20 S Laurel,NE (402) The Medicine Shoppe # Court St Beatrice,NE (402) The Pharmacy 1221 N Cotner Blvd Ste 1 Lincoln,NE (402) Tooley Drug Co Th St Columbus,NE (402) Valley Pharmacy 123 E Gardiner St Valley,NE (402) Village Pharmacy Inc 300 S 1St Ave Hastings,NE (402) Wagey Drug 800 N 27Th St Lincoln,NE (402) Wahoo Pharmacy & Gifts 526 N Linden St Wahoo,NE (402) Wanek Family Pharmacy 410 Main St Neligh,NE (402) Westfield Pharmacy 1845 W A St North Platte,NE (800) Wragge Pharmacy 332 S 13Th St Tekamah,NE (402) NEBRASKA

107 Indian Health Service/Tribal/ Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through the plan s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. NEBRASKA 107

108 NEBRASKA Native Plains Pharmacy 701 Buffalo Trail Winnebago,NE (402) Winnebago Ihs Hospital Phcy PO Box Hh Winnebago,NE (402) NE I/T/U Pharmacies NEBRASKA

109 NORTH DAKOTA

110

111 Retail Pharmacies NORTH DAKOTA 111

112 NORTH DAKOTA BARNES Valley City Central Avenue Pharmacy 323 Central Ave N Valley City,ND (701) BENSON Fort Totten Spirit Lake Health Center PO Box 309 Fort Totten,ND (701) BOWMAN Bowman The Bowman Drug Company 12 N Main St Bowman,ND (701) BURLEIGH Bismarck Gateway Healthmart Pharmacy Sou 835 S Washington St Ste 2 Bismarck,ND (701) Gateway Pharmacy North 3101 N 11Th St Ste 2 Bismarck,ND (701) Professional Pharmacy 2215 E Main Ave. #5 Bismarck,ND (701) The Medicine Shoppe Phcy # E Blvd Ave Bismarck,ND (701) CASS Casselton Casselton Drug 622 Front St Casselton,ND (701) Fargo Meritcare Broadway Pharmacy 737 Broadway Fargo,ND (701) Metro Drug Co 123 Broadway Fargo,ND (701) The Medicine Shoppe # S University Dr Fargo,ND (701) The Medicine Shoppe # Broadway N Fargo,ND (701) CAVALIER Langdon Langdon Community Drug 706 3Rd St Langdon,ND (701) DICKEY Oakes Tara's Thrifty White LLC 610 Main Ave Oakes,ND (701) DIVIDE Crosby J Co Drug 120 N Main St Crosby,ND (701) DUNN Killdeer Killdeer Pharmacy Inc 14 Central Ave S Killdeer,ND (701) EDDY New Rockford Seaburg Drug Inc 4 8Th St N New Rockford,ND (701) FOSTER Carrington Carrington Drug Inc 415 Main St Carrington,ND (701) Seaburg Drug Inc 990 Main St Carrington,ND (701) GOLDEN VALLEY Beach Beach Pharmacy 95 Central Ave S Beach,ND (701) GRAND FORKS Grand Forks Family Medicine Residency Pharma 725 Hamline St Grand Forks,ND (701) GRANT Elgin Economy Drug Incorporated 201 N Main St Elgin,ND (701) HETTINGER Mott Mott Drug Store 216 Brown Ave Mott,ND (701) New England New England Drug 107 Main St New England,ND (701) LA MOURE Edgeley The Prescription Shop 509 2Nd St Edgeley,ND (701) Lamoure Lamoure Drug Store Omega City Plaza 100 1St Ave Lamoure,ND (701) ND Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 112 NORTH DAKOTA 163

113 ND MC HENRY NELSON STARK WARD Velva Lakota Dickinson Minot Retail Pharmacies Velva Drug Co 16 Main St N Velva,ND (701) MC KENZIE Watford City Barrett Pharmacy 145 N Main St Watford City,ND (701) MERCER Beulah Beulah Drug 147 W Main St Beulah,ND (701) MORTON Mandan Gateway Healthmart Pharmacy Mand 500 Burlington St SE Mandan,ND (701) The Medicine Shoppe # St St NW Mandan,ND (701) MOUNTRAIL New Town Minne-Tohe Health Center Highway 23 West New Town,ND (701) Lakota Drug 117 Main St Lakota,ND (701) RANSOM Enderlin Enderlin Pharmacy 308 Railway St Enderlin,ND (701) Lisbon Sheyenne Valley Drug 407 Main St Lisbon,ND (701) RICHLAND Hankinson Hankinson Drug 309 Main Ave S Hankinson,ND (701) ROLETTE Belcourt Quentin Burdick Memorial PO Box 160 Belcourt,ND (701) SIOUX Ft Yates Fort Yates Health Center PO Box J Ft Yates,ND (701) Clinic Pharmacy Inc 938 2Nd Ave W Dickinson,ND (701) Nd Pharmacy Inc # Th St W Ste 2 Dickinson,ND (701) The Medicine Shoppe # W Villard St Dickinson,ND (701) STUTSMAN Jamestown The Medicine Shoppe # St Ave S Jamestown,ND (701) Walz Pharmacy Inc 213 1St Ave N Jamestown,ND (701) TRAILL Hillsboro Hillsboro Drug 13 N Main St Hillsboro,ND (701) WALSH Park River Ye Olde Medicine Center 503 Park St W Park River,ND (701) B & B Northwest Pharmacy 20 Burdick Expy West Ste 107 Minot,ND (701) Market Pharmacy 1930 S Broadway Minot,ND (701) The Medicine Shoppe # Th Ave SW Minot,ND (701) WELLS Fessenden Nilles Drug Inc 58 Main Ave S Fessenden,ND (701) Harvey Service Drug & Gift 815 Lincoln Ave Harvey,ND (701) The Medicine Shoppe # Lincoln Ave Harvey,ND (701) WILLIAMS Trenton Trenton Community Clinic 331 4Th Ave E Trenton,ND (701) This pharmacy does not offer extended supplies of maintenance medications. NORTH DAKOTA 113

114 Williston Nd Pharmacy Inc # Th St E Williston,ND (701) Service Drug Pharmacy 317 Main St Williston,ND (701) ND Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications NORTH DAKOTA

115 Chain Pharmacies NORTH DAKOTA 115

116 NORTH DAKOTA ADAMS Hettinger White Drug # S Main St Hettinger,ND (701) BARNES Valley City White Drug # Nd Ave NW Valley City,ND (701) White Drug # Central Ave S Valley City,ND (701) BENSON Maddock White Drug # Central Ave Maddock,ND (701) BURLEIGH Bismarck CVS Pharmacy # State St Bismarck,ND (701) CVS Pharmacy # S 5Th St Bismarck,ND (701) White Drug # N 5Th St Bismarck,ND (701) CASS Fargo CVS Pharmacy # Th Ave S Fargo,ND (701) CVS Pharmacy # Th Ave N Fargo,ND (701) Innovis Health Nd Ave SW Fargo,ND (952) Rapid Care Nd Ave S Fargo,ND (952) White Drug # Rd St SW Fargo,ND (701) White Drug # C 38Th St NW # C Fargo,ND (701) White Drug # Th St NW Fargo,ND (701) White Drug # University Dr S Fargo,ND (701) West Fargo White Drug # Th Ave E West Fargo,ND (701) GRAND FORKS Grand Forks CVS Pharmacy # Nd Ave S Grand Forks,ND (701) Medicap Pharmacy # S Columbia Rd Ste C Grand Forks,ND (701) Thrifty White # S Washington St Grand Forks,ND (701) White Drug # S Columbia Rd Grand Forks,ND (701) MC INTOSH Ashley White Drug # W Main St Ashley,ND (701) MORTON Mandan Thrifty-White # St St NW Mandan,ND (701) PEMBINA Cavalier White Drug # E 3Rd Ave S Cavalier,ND (701) PIERCE Rugby White Drug # Nd St SE Rugby,ND (701) RAMSEY Devils Lake Bell Drug # Th St Devils Lake,ND (701) White Drug # College Dr S Ste 10 Devils Lake,ND (701) RENVILLE Loraine White Drug # Main St Loraine,ND (701) ROLETTE Rolette White Drug # Main St Rolette,ND (701) STARK Dickinson White Drug # Rd Ave W Dickinson,ND (701) ND Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 116 NORTH DAKOTA 883

117 ND STUTSMAN Jamestown White Drug # Th St SE Jamestown,ND (701) White Drug # St Ave S Jamestown,ND (701) WALSH Grafton White Drug # Hill Ave Grafton,ND (701) WARD Minot Chain Pharmacies CVS Pharmacy # Th St SW Minot,ND (701) White Drug # S Broadway Minot,ND (701) White Drug # Nd Ave SW Minot,ND (701) WILLIAMS Williston White Drug # Th St W Williston,ND (701) This pharmacy does not offer extended supplies of maintenance medications. NORTH DAKOTA 117

118 Mail Order Pharmacies 118 NORTH DAKOTA

119 Mail-Order Pharmacies Medco By Mail Contact the Medco By Mail Customer Service department using the contact information on the front cover. TTY/TDD users should call Liberty Medical TTY/TDD users should call Mail-Order Pharmacies 1327 NORTH DAKOTA 119

120 Home Infusion Pharmacies This plan will cover home infusion therapy if: Your prescription drug is on the plan s formulary or you have a formulary exception. The Plan has approved your prescription drug for home infusion therapy. Your prescription is written by an authorized prescriber. Home infusion pharmacies specialize in the preparation of medications that are administered intravenously or by injection. To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 120 NORTH DAKOTA

121 NORTH DAKOTA Meritcare Broadway Pharmacy 737 Broadway Fargo,ND (701) ND Home Infusion Pharmacies 1385 NORTH DAKOTA 121

122 Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under the Plan through the facility s longterm care pharmacy or another network long-term care pharmacy. A long-term care pharmacy provides medications to residents of long-term care facilities (such as nursing homes and residential care facilities, mental health facilities, hospices, and long-term care or skilled nursing care beds in hospitals). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 122 NORTH DAKOTA

123 NORTH DAKOTA Arthur Drug 325 Main St Arthur,ND (701) Barrett Pharmacy 145 N Main St Watford City,ND (701) Bell Drug # Th St Devils Lake,ND (701) Casselton Drug 622 Front St Casselton,ND (701) Medical Pharmacy Inc 100 4Th St S Fargo,ND (701) Medicap Pharmacy # S Columbia Rd Ste C Grand Forks,ND (701) Nd Pharmacy Inc # Th St E Williston,ND (701) Professional Pharmacy 1016 N 28Th St Bismarck,ND (701) The Medicine Shoppe # St Ave S Jamestown,ND (701) The Medicine Shoppe # S Washington St Grand Forks,ND Thrifty Drug Ltd 1521 S University Dr Fargo,ND (701) Thrifty White # S Washington St Grand Forks,ND (701) Thrifty-White # St St NW Mandan,ND (701) White Drug # N 5Th St Bismarck,ND (701) White Drug # Th St SE Jamestown,ND (701) White Drug # S Broadway Minot,ND (701) White Drug # S Columbia Rd Grand Forks,ND (701) White Drug # Rd Ave W Dickinson,ND (701) White Drug # Rd St SW Fargo,ND (701) White Drug # Nd Ave SW Minot,ND (701) White Drug # St Ave S Jamestown,ND (701) White Drug # Th Ave E West Fargo,ND (701) White Drug # Nd St SE Rugby,ND (701) White Drug # Th St NW Fargo,ND (701) White Drug # E 3Rd Ave S Cavalier,ND (701) White Drug # S Main St Hettinger,ND (701) White Drug # Central Ave Maddock,ND (701) White Drug # Main St Rolette,ND (701) White Drug # Nd Ave NW Valley City,ND (701) White Drug # Central Ave S Valley City,ND (701) White Drug # Main St Loraine,ND (701) White Drug # College Dr S Ste 10 Devils Lake,ND (701) White Drug # Hill Ave Grafton,ND (701) ND Long-Term Care Pharmacies 1503 NORTH DAKOTA 123

124 Indian Health Service/Tribal/ Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through the plan s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 124 NORTH DAKOTA

125 NORTH DAKOTA Fort Yates Health Center PO Box J Ft Yates,ND (701) Minne-Tohe Health Center Highway 23 West New Town,ND (701) Quentin Burdick Memorial PO Box 160 Belcourt,ND (701) Spirit Lake Health Center PO Box 309 Fort Totten,ND (701) Trenton Community Clinic 331 4Th Ave E Trenton,ND (701) ND I/T/U Pharmacies 1591 NORTH DAKOTA 125

126

127 SOUTH DAKOTA

128

129 Retail Pharmacies SOUTH DAKOTA 129

130 SOUTH DAKOTA BON HOMME Scotland Scotland Pharmacy 620 Billars St Scotland,SD (605) Tyndall Bon Homme Pharmacy 410 W 16Th Ave Tyndall,SD (605) Hoch Drug 1619 Main St Tyndall,SD (605) BROOKINGS Brookings SD State University Jackrabbit P 907 Harvey Dunn St Rm 214 Brookings,SD (605) BROWN Aberdeen Avera St Luke's Hospital Pharmac 305 S State St Aberdeen,SD (605) Dt Pharmacy 815 1St Ave SE Ste 202 Aberdeen,SD (605) BUFFALO Fort Thompson Fort Thompson Health Center Hwy 47 Fort Thompson,SD (605) CHARLES MIX Wagner Wagner Health Center 110 Washington St Wagner,SD (605) CLAY Vermillion Davis Pharmacy Ltd 5 W Cherry St Vermillion,SD (605) CODINGTON Watertown Genoa Healthcare of S Dakota LLC Th St NE Watertown,SD (605) Prairie Lakes Hosp Phcy Th Ave NW Watertown,SD (605) CORSON Mclaughlin McLaughlin Ihs Clinic Pharmacy 701 E 6Th St Mclaughlin,SD (605) DAVISON Mitchell The Medicine Shoppe # N Main St Mitchell,SD (605) DEWEY Eagle Butte Eagle Butte Ihs Hospital 317 Main St Eagle Butte,SD (605) EDMUNDS Bowdle Turner Drug 3033 Main Bowdle,SD (605) Ipswich Crissman Drug 33 Main St Ipswich,SD (605) FALL RIVER Hot Springs Fall River Health Services 209 N 16Th St Hot Springs,SD (605) GRANT Milbank Dans Pharmacy 222 S Main St Milbank,SD (605) HUGHES Pierre The Medicine Shoppe # E Sioux Ave Ste 1 Pierre,SD (605) Vilas Ltc Pharmacy 220 E Dakota Ave Ste 2 Pierre,SD (605) HUTCHINSON Parkston Neumayr Pharmcy 112 W Main St Parkston,SD (605) The Medicine Shoppe # West Main St Ste A Parkston,SD (605) JACKSON Wanblee Wanblee Health Center 100 Clinic Dr Wanblee,SD (605) LINCOLN Tea Medicap Pharmacy # E 1St St Tea,SD (605) LYMAN Lower Brule Lower Brule Health Center PO Box 248 Lower Brule,SD (605) SD Retail Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 130 SOUTH DAKOTA 265

131 SD Retail Pharmacies MEADE Sturgis County Drug Inc 1111 Lazelle St Sturgis,SD (605) MINNEHAHA Hartford Medicap Pharmacy # W Hwy 38 Ste 102 Hartford,SD (605) Sioux Falls Lewis Long Term Care Pharmacy 2701 S Minnesota Ave Sioux Falls,SD (605) Omnicare of South Dakota 709 N Kiwanis Ave Sioux Falls,SD (605) Vanhove Prescription Shop 1200 S 7Th Ave Sioux Falls,SD (605) MOODY Medicap Pharmacy 2201 Jackson Blvd #101 Rapid City,SD (605) Medicine Shoppe Advanced Care Ph 1308 Mount Rushmore Rd Rapid City,SD (605) Rapid City Regional Hospital Phc 353 Fairmont Blvd Rapid City,SD (605) Sioux San Hospital 3200 Canyon Lake Dr Rapid City,SD (605) The Medicine Shoppe Phcy # Mount Rushmore Rd Rapid City,SD (605) ROBERTS Sisseton Pearson Drug And Jewelry 420 Veterans Ave Sisseton,SD (605) Pine Ridge Pine Ridge Ihs Hospital PO Box 1201 Pine Ridge,SD (605) TODD Rosebud Rosebud Indian Hospital PO Box 400 Rosebud,SD (605) UNION Elk Point Pioneer Drug 107 E Main St Elk Point,SD (605) YANKTON Yankton Avera Sacred Heart Pharmacy 501 Summit St Yankton,SD (605) Flandreau Flandreau Santee Sioux Tribal Ph 701 W Broad Ave Flandreau,SD (605) PENNINGTON Rapid City Medicap Pharmacy 339 Saint Patrick St Rapid City,SD (605) Sisseton Hospital 5 Chestnut St Sisseton,SD (605) SHANNON Kyle Kyle Health Center 1000 Health Center Rd Kyle,SD (605) This pharmacy does not offer extended supplies of maintenance medications. SOUTH DAKOTA 131

132 Chain Pharmacies 132 SOUTH DAKOTA

133 SOUTH DAKOTA BEADLE Huron Coborn's Pharmacy # Dakota Ave S Huron,SD (605) K Mart # Th St SW Huron,SD (605) Lewis Drug Huron # Dakota Ave S Huron,SD (605) Wal*Mart Phcy # Dakota Ave S Huron,SD (605) BROOKINGS Brookings Hy-Vee Pharmacy # Nd Ave S Brookings,SD (605) Lewis Drug # Nd Ave S Brookings,SD (605) Wal*Mart # Th St Brookings,SD (605) BROWN Aberdeen Econofoods Pharmacy # Th Ave SE Aberdeen,SD (605) K Mart # Th Ave SE Aberdeen,SD (605) Shopko Pharmacy # N Highway 281 Aberdeen,SD (605) Wal*Mart # Th Ave SE Aberdeen,SD (605) BUTTE Belle Fourche Pamida #360 1 N 5Th Ave Belle Fourche,SD (605) CLAY Vermillion Hy-Vee Pharmacy # W Cherry St Vermillion,SD (605) Wal*Mart Phcy # Princeton St Vermillion,SD (605) CODINGTON Watertown Econofoods Pharmacy # Th Ave SE Watertown,SD (605) Hy-Vee Pharmacy # Th Ave SE Watertown,SD (605) Hy-Vee Pharmacy Clinic # Th St SE Ste 3 Watertown,SD (605) Shopko Pharmacy # Th Ave SE Watertown,SD (605) Wal*Mart # Th Ave SE Watertown,SD (605) Walgreens # Th Ave SE Watertown,SD (605) DAVISON Mitchell K Mart # S Burr St Mitchell,SD (605) Shopko Pharmacy # N Main St Mitchell,SD (605) Wal*Mart Phcy # East Spruce St Mitchell,SD (605) Walgreens # W Havens St Mitchell,SD (605) FALL RIVER Hot Springs Pamida # Highway 18 W Hot Springs,SD (605) HUGHES Pierre K Mart # N Harrison Ave Pierre,SD (605) Wal*Mart # N Harrison Ave Pierre,SD (605) Walgreens # E Sioux Ave Pierre,SD (605) KINGSBURY Lake Preston Lewis Famliy Drug # Main Ave North Lake Preston,SD (605) LAKE Madison Pamida # S Washington Ave Madison,SD (605) LAWRENCE Spearfish K Mart # E Colorado Blvd Spearfish,SD (605) Medicap Pharmacy # North Ave Spearfish,SD (605) Safeway Pharmacy # North Ave Spearfish,SD (605) SD Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications SOUTH DAKOTA 133

134 SD Chain Pharmacies Wal*Mart # N Main St Spearfish,SD (605) LINCOLN Beresford Lewis Family Drug # N 3Rd St Beresford,SD (605) Canton Lewis Family Drug # E 5Th St Canton,SD (605) Lennox Lewis Family Drug #63 21 S Main Lennox,SD (605) Sioux Falls Lewis Drug # E 57Th St Sioux Falls,SD (605) Tea Lewis Drugs # E 1St St Tea,SD (605) MEADE Sturgis Pamida Pharmacy # Lazelle St Sturgis,SD (605) MINNEHAHA Brandon Lewis Drug #9 117 N Splitrock Blvd Brandon,SD (605) Dell Rapids Lewis Family Drug # E 4Th St Dell Rapids,SD (605) Sioux Falls Hy-Vee Pharmacy # S Sycamore Ave Sioux Falls,SD (605) Hy-Vee Pharmacy # S Louise Ave Sioux Falls,SD (605) Hy-Vee Pharmacy # S Minnesota Ave Sioux Falls,SD (605) Hy-Vee Pharmacy # S Marion Rd Sioux Falls,SD (605) Hy-Vee Pharmacy # E 10Th St Sioux Falls,SD (605) K Mart # E 10Th St Sioux Falls,SD (605) K Mart # W 12Th St Sioux Falls,SD (605) Lewis Drug Eastgate # E 10Th St Sioux Falls,SD (605) Lewis Drug Southeast # E 26Th St Sioux Falls,SD (605) Lewis Drug Southgate #1 500 W 41St St Sioux Falls,SD (605) Lewis Drug Southwest # W 41St St Sioux Falls,SD (605) Lewis Drug Westgate # W 12Th St Sioux Falls,SD (605) Lewis Family Drug # S Euclid Ave Sioux Falls,SD (605) Lewis Family Drug # W 41St St Sioux Falls,SD (605) Lewis Family Pharmacy # S Minnesota Ave Sioux Falls,SD (605) Pharmerica # W 51St St Sioux Falls,SD (605) Sam's Pharmacy # S Louise Ave Sioux Falls,SD (605) Shopko Pharmacy # W 41St St Sioux Falls,SD (605) Shopko Pharmacy # E Arrowhead Pkwy Sioux Falls,SD (605) Target #T S Louise Ave Sioux Falls,SD (605) Wal*Mart # S Louise Ave Sioux Falls,SD (605) Wal*Mart Phcy # E 12Th St Sioux Falls,SD (605) Walgreens # S Sycamore Ave Sioux Falls,SD (605) Walgreens # N Cliff Ave Sioux Falls,SD (605) Walgreens # W 12Th St Sioux Falls,SD (605) Walgreens # S Minnesota Ave Sioux Falls,SD (605) Walgreens # W 41St St Sioux Falls,SD (605) Walgreens # W 41St St Sioux Falls,SD (605) MOODY Flandreau Lewis Family Drug # E 2Nd Ave Flandreau,SD (605) This pharmacy does not offer extended supplies of maintenance medications. 134 SOUTH DAKOTA

135 PENNINGTON Rapid City Albertsons/Osco Pharmacy # Omaha St Rapid City,SD (605) Family Thrift Center 855 Omaha St Rapid City,SD (605) Family Thrift Ctr # E Saint Patrick St Rapid City,SD (605) Ftc Express Pharmacy # Sturgis Rd Rapid City,SD (605) K Mart # E North St Rapid City,SD (605) Pharmerica # Th St Ste 109 Rapid City,SD (605) Rapidcare 408 Knollwood Dr Rapid City,SD (952) Wal*Mart # N Lacrosse St Rapid City,SD (605) Walgreens # Mountain View Rd Rapid City,SD (704) Walgreens # N La Crosse St Rapid City,SD (605) Walgreens # Mount Rushoer Rd Rapid City,SD (605) ROBERTS Sisseton Pamida Pharmacy # Veterans Ave Sisseton,SD (605) TRIPP Winner Pamida Pharmacy # E 5Th St Winner,SD (605) TURNER K Mart # Broadway St Yankton,SD (605) Wal*Mart # Broadway St Yankton,SD (605) Walgreens # Broadway Ave Yankton,SD (605) SD Chain Pharmacies Safeway Pharmacy # Mountain View Rd Rapid City,SD (605) Safeway Pharmacy # Mount Rushmore Rd Rapid City,SD (605) Viborg Lewis Family Drug # S Main St Viborg,SD (605) YANKTON Yankton Shopko Pharmacy # N Haines Ave Rapid City,SD (605) Hy-Vee Pharmacy # Broadway St Yankton,SD (605) This pharmacy does not offer extended supplies of maintenance medications SOUTH DAKOTA 135

136 Mail Order Pharmacies 136 SOUTH DAKOTA

137 Mail-Order Pharmacies Medco By Mail Contact the Medco By Mail Customer Service department using the contact information on the front cover. TTY/TDD users should call Liberty Medical TTY/TDD users should call Mail-Order Pharmacies 1327 SOUTH DAKOTA 137

138 Home Infusion Pharmacies This plan will cover home infusion therapy if: Your prescription drug is on the plan s formulary or you have a formulary exception. The Plan has approved your prescription drug for home infusion therapy. Your prescription is written by an authorized prescriber. Home infusion pharmacies specialize in the preparation of medications that are administered intravenously or by injection. To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 138 SOUTH DAKOTA

139 SOUTH DAKOTA Hansen Community Drug 321 S Main St Winner,SD SD Home Infusion Pharmacies 1413 SOUTH DAKOTA 139

140 Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under the Plan through the facility s longterm care pharmacy or another network long-term care pharmacy. A long-term care pharmacy provides medications to residents of long-term care facilities (such as nursing homes and residential care facilities, mental health facilities, hospices, and long-term care or skilled nursing care beds in hospitals). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 140 SOUTH DAKOTA

141 SOUTH DAKOTA Avera Sacred Heart Pharmacy 501 Summit St Yankton,SD (605) Avera St Luke's Hospital Pharmac 305 S State St Aberdeen,SD (605) Dt Pharmacy 815 1St Ave SE Ste 202 Aberdeen,SD (605) Fall River Health Services 209 N 16Th St Hot Springs,SD (605) Genoa Healthcare of S Dakota LLC Th St NE Watertown,SD (605) Hy-Vee Pharmacy # Nd Ave S Brookings,SD (605) Lewis Family Drug #5 741 S Washington Ave Madison,SD (605) Lewis Long Term Care Pharmacy 2701 S Minnesota Ave Sioux Falls,SD (605) Pamida # S Washington Ave Madison,SD (605) Pamida # Highway 18 W Hot Springs,SD (605) Pamida #360 1 N 5Th Ave Belle Fourche,SD (605) Pamida Pharmacy # E 5Th St Winner,SD (605) Pamida Pharmacy # Lazelle St Sturgis,SD (605) Pharmerica # W 51St St Sioux Falls,SD (605) Pharmerica # Th St Ste 109 Rapid City,SD (605) The Medicine Shoppe # N Main St Mitchell,SD (605) The Medicine Shoppe # West Main St Ste A Parkston,SD (605) Turner Drug 3033 Main Bowdle,SD (605) Vilas Ltc Pharmacy 220 E Dakota Ave Ste 2 Pierre,SD (605) SD Long-Term Care Pharmacies Medicap Pharmacy # Jackson Blvd Ste 101 Rapid City,SD (605) Omnicare of South Dakota 709 N Kiwanis Ave Sioux Falls,SD (605) SOUTH DAKOTA 141

142 Indian Health Service/Tribal/ Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through the plan s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 142 SOUTH DAKOTA

143 SOUTH DAKOTA Eagle Butte Ihs Hospital 317 Main St Eagle Butte,SD (605) Flandreau Santee Sioux Tribal Ph 701 W Broad Ave Flandreau,SD (605) Fort Thompson Health Center Hwy 47 Fort Thompson,SD (605) Kyle Health Center 1000 Health Center Rd Kyle,SD (605) Lower Brule Health Center PO Box 248 Lower Brule,SD (605) McLaughlin Ihs Clinic Pharmacy 701 E 6Th St Mclaughlin,SD (605) Pine Ridge Ihs Hospital PO Box 1201 Pine Ridge,SD (605) Sisseton Hospital 5 Chestnut St Sisseton,SD (605) Wagner Health Center 110 Washington St Wagner,SD (605) Wanblee Health Center 100 Clinic Dr Wanblee,SD (605) SD I/T/U Pharmacies Rosebud Indian Hospital PO Box 400 Rosebud,SD (605) Sioux San Hospital 3200 Canyon Lake Dr Rapid City,SD (605) SOUTH DAKOTA 143

144

145 WYOMING

146

147 Retail Pharmacies WYOMING 147

148 WYOMING CAMPBELL Gillette Medicap Pharmacy # E Lakeway Rd #A Gillette,WY (307) CARBON Rawlins Bi Rite Professional Pharmacy 300 3Rd St Rawlins,WY (307) Saratoga Valley Pharmacy 1504 S 1St St Saratoga,WY (307) FREMONT Arapahoe Arapahoe Health Center Pharmacy 14 Great Plains Rd Arapahoe,WY (307) Fort Washakie Hoys Drug 1115 E Pershing Blvd Cheyenne,WY (307) Hoy's Hospital Pharmacy 2301 House Ave Ste 101 Cheyenne,WY (307) NATRONA Casper Bi Rite Drug Store 428 S Durbin St Casper,WY (307) PARK Cody West Park Hospital District 707 Sheridan Ave Cody,WY (307) WY Retail Pharmacies Fort Washakie Hlth Ctr Pharmacy Blackcoal Dr Bldg 29 Fort Washakie,WY (307) LARAMIE Cheyenne Genoa Healthcare of Wy LLC 2526 Seymour Ave Cheyenne,WY (307) This pharmacy does not offer extended supplies of maintenance medications. 148 WYOMING 315

149 Chain Pharmacies WYOMING 149

150 ALBANY Laramie WYOMING K Mart # N 3Rd St Laramie,WY (307) Osco Pharmacy # E Grand Ave Laramie,WY (307) Safeway Pharmacy # N 3Rd St Laramie,WY (307) Wal*Mart # Grand Ave Laramie,WY (307) BIG HORN Greybull Pamida Pharmacy # Greybull Ave Greybull,WY (307) CAMPBELL Gillette K Mart # S Douglas Hwy Gillette,WY (307) Osco Pharmacy # S Douglas Hwy Gillette,WY (307) Smiths Pharmacy # Camel Dr Gillette,WY (307) Wal*Mart # S Douglas Hwy Gillette,WY (307) Walgreens # S Douglas Hwy Gillette,WY (307) Wright Campbell Cty Wright Clnic 500 Latigo Dr Wright,WY (307) CARBON Rawlins City Market # N Higley Blvd Rawlins,WY (307) Pamida # E Cedar St Rawlins,WY (307) CONVERSE Douglas Pamida Pharmacy # E Richards St Douglas,WY (307) Safeway Pharmacy # E Richards St Douglas,WY (307) FREMONT Riverton K Mart # N Federal Blvd Riverton,WY (307) Safeway Pharmacy # N Federal Blvd Riverton,WY (307) Smiths Pharmacy # W Main St Riverton,WY (307) Wal*Mart # N Federal Blvd Riverton,WY (307) Walgreens # N Federal Blvd Riverton,WY (307) GOSHEN Torrington Pamida Pharmacy # E Valley Rd Torrington,WY (307) LARAMIE Cheyenne K Mart # Dell Range Blvd Cheyenne,WY (307) King Soopers # Dell Range Blvd Cheyenne,WY (307) Medicap Pharmacy # Bluegrass Cir Cheyenne,WY (307) Osco Pharmacy # E Pershing Blvd Cheyenne,WY (307) Osco Pharmacy # Yellowstone Rd Cheyenne,WY (307) Safeway Pharmacy # S Greeley Hwy Cheyenne,WY (307) Safeway Pharmacy Cole Shopping Ctr Cheyenne,WY (307) Wal*Mart # Dell Range Blvd Cheyenne,WY (307) Walgreens # E Lincolnway Cheyenne,WY (307) Walgreens # Stillwater Ave Cheyenne,WY (307) LINCOLN Afton Pamida Pharmacy # N Washington St Afton,WY (307) Thayne Pamida Pharmacy # N Main St Thayne,WY (307) NATRONA Casper K Mart # E 2Nd St Casper,WY (307) WY Chain Pharmacies This pharmacy does not offer extended supplies of maintenance medications. 150 WYOMING 1323

151 WY Osco Pharmacy # Cy Ave Casper,WY (307) Osco Pharmacy # E 2Nd St Casper,WY (307) Safeway Pharmacy # Cy Ave Casper,WY (307) Wal*Mart # Yellowstone Ave Cody,WY (307) Powell Pamida Pharmacy # W Coulter Ave Powell,WY (307) PLATTE Wheatland SWEETWATER Green River Pamida Pharmacy # Bridger Dr Green River,WY (307) Smiths Pharmacy # Bridger Dr Green River,WY (307) Rock Springs Jackson Hole Smith's Pharmacy # South Hwy 89 Jackson Hole,WY (307) UINTA Evanston Smiths Pharmacy #86 70 Yellow Creek Rd Evanston,WY (307) Chain Pharmacies Safeway Pharmacy # SE Wyoming Blvd Casper,WY (307) Smiths Pharmacy # Cy Ave Casper,WY (307) Wal*Mart # E 2Nd St Casper,WY (307) Wal*Mart Phcy # Cy Ave Casper,WY (307) Walgreens # SE Wyoming Blvd Casper,WY (307) Walgreens # E C St # Y Casper,WY (307) PARK Cody Osco Pharmacy # Th St Cody,WY (307) Pamida # Th St Wheatland,WY (307) SHERIDAN Sheridan K Mart # N Business 90 Sheridan,WY (307) Osco Pharmacy # Coffeen Ave Sheridan,WY (307) Safeway Pharmacy # Coffeen Ave Sheridan,WY (307) Wal*Mart # Coffeen Ave Sheridan,WY (307) Walgreens # Coffeen Ave Sheridan,WY (307) Albertsons/Sav-On Phcy # Dewar Dr Rock Springs,WY (307) K Mart # Foothill Blvd Rock Springs,WY (307) Smiths Pharmacy # Foothill Blvd Rock Springs,WY (307) Wal*Mart # Gateway Blvd Rock Springs,WY (307) Walgreens # Gateway Blvd Rock Springs,WY (307) TETON Jackson Albertsons/Sav-On Phcy # Buffalo Way Jackson,WY (307) K Mart # S Highway #89 Jackson,WY (307) Wal*Mart Phcy # Beckers Cir Evanston,WY (307) Lyman Pamida Pharmacy # S Main St Lyman,WY (307) WASHAKIE Worland Pamida # S 20Th St Worland,WY (307) WESTON Newcastle Pamida # Boyd Ave Newcastle,WY (307) This pharmacy does not offer extended supplies of maintenance medications. WYOMING 151

152 Mail Order Pharmacies 152 WYOMING

153 Mail-Order Pharmacies Medco By Mail Contact the Medco By Mail Customer Service department using the contact information on the front cover. TTY/TDD users should call Liberty Medical TTY/TDD users should call Mail-Order Pharmacies 1327 WYOMING 153

154 Home Infusion Pharmacies This plan will cover home infusion therapy if: Your prescription drug is on the plan s formulary or you have a formulary exception. The Plan has approved your prescription drug for home infusion therapy. Your prescription is written by an authorized prescriber. Home infusion pharmacies specialize in the preparation of medications that are administered intravenously or by injection. To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 154 WYOMING

155 WYOMING Care Trust IV 1030 N Poplar St Ste A Casper,WY (307) Coram Healthcare of Wy LLC 1507 Stillwater Ave Ste C Cheyenne,WY Rock Springs IV Center 400 2Nd St Ste 81 Rock Springs,WY (307) WY Home Infusion Pharmacies 1431 WYOMING 155

156 Long Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under the Plan through the facility s longterm care pharmacy or another network long-term care pharmacy. A long-term care pharmacy provides medications to residents of long-term care facilities (such as nursing homes and residential care facilities, mental health facilities, hospices, and long-term care or skilled nursing care beds in hospitals). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 156 WYOMING

157 WYOMING Bi Rite Drug Store 428 S Durbin St Casper,WY (307) Bi Rite Professional Pharmacy 300 3Rd St Rawlins,WY (307) Genoa Healthcare of Wy LLC 2526 Seymour Ave Cheyenne,WY (307) Medicap Pharmacy # Bluegrass Cir Cheyenne,WY (307) Pamida # Th St Wheatland,WY (307) Pamida # E Cedar St Rawlins,WY (307) Pamida Pharmacy # W Coulter Ave Powell,WY (307) WY Long-Term Care Pharmacies Valley Pharmacy 1504 S 1St St Saratoga,WY (307) West Park Hospital District 707 Sheridan Ave Cody,WY (307) WYOMING 157

158 Indian Health Service/Tribal/ Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through the plan s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). To find out more, please visit our website or call our Customer Service department using the information provided on the front cover of this directory. 158 WYOMING

159 WYOMING Arapahoe Health Center Pharmacy 14 Great Plains Rd Arapahoe,WY (307) Fort Washakie Hlth Ctr Pharmacy Blackcoal Dr Bldg 29 Fort Washakie,WY (307) WY I/T/U Pharmacies 1615 WYOMING 159

160 Prescription Drug Coverage UNITED AMERICAN INSURANCE COMPANY P.O. BOX 8080 MCKINNEY, TX FORWARDING SERVICE REQUESTED