340B Drug Pricing Program Database


DSH240043P MAYO CLNIC HLTH SYS-ALBRT LEA AUSTIN (Approved) - information as of 5/16/2025 11:30:40 PM

Main Details
MAYO CLNIC HLTH SYS-ALBRT LEA AUSTIN
MAYO CLINIC HEALTH SYSTEM ALBERT LE - Allergy
Disproportionate Share Hospital
Yes
DSH240043P
240043


Additional Details
Approved
4/14/2025
7/1/2025
4/22/2025

Contacts

Mayo Clinic
Travis C. Paul, Regional Chair of Administration SWMN
(608) 392-9716

Mayo Clinic Health System
Matt Lemin, Program Manager
(507) 293-3853

Addresses

404 W FOUNTAIN ST
ALBERT LEA, MN 56007-2437

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

MAYO CLINIC HEALTH SYSTEM-ALBERT LEA AND AUSTIN
1000 1ST DRIVE NW
AUSTIN, MN 55912

MCHS ALBERT LEA
MAYO CLINIC HEALTH SYSTEM PHARMACY
404 W FOUNTAIN STREET
ALBERT LEA, MN 56007

MCHS Albert Lea
Austin Hospital Pharmacy
1000 1st Drive NW
Austin, MN 55912

MCHS Albert Lea
Albert Lea Outpatient Pharmacy
404 W Fountain Street
Albert Lea, MN 56007

MCHS Albert Lea
Albert Lea Hospital Pharmacy
404 W Fountain Street
Albert Lea, MN 56007

MCHS Albert Lea
Austin Outpatient Pharmacy
1000 1st Drive NW
Austin, MN 55912
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH240043AChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Occupational Medicine404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043AAChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Diagnostic Radiology404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043ABChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Wound Care404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043ACChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Urology404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043ADChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Pulmonary Rehab404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043AEChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Anticoagulation404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043AFChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Radiology404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043AGChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Medication Therapy Management404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043AHChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - ENT404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043BChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Endocrinology404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043CChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Pediatrics404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043DChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Orthopedic Surgery404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043EChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Nicotine Dependence404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043FChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Pulmonary Medicine404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043GChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Neurology404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043HChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Dermatology404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043JChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Physical Medicine & Rehab404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043KChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Emergency Medicine404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043LChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Infusion404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043MChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Hematology/Oncology404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043NChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Endoscopy404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043PChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Allergy404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043QChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Neurosurgery404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043RChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - OB/GYN404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043SChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Operating Room404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043TChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - General Surgery404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043UChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Cardiac Rehabilitation404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043VChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Family Medicine404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043WChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Sleep Medicine404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043XChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Pulmonary Diagnostics404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043YChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Internal Medicine404 W FOUNTAIN STALBERT LEAMNApproved
DSH240043ZChildDSHMAYO CLNIC HLTH SYS-ALBRT LEA AUSTINMAYO CLINIC HEALTH SYSTEM ALBERT LE - Cardiovascular404 W FOUNTAIN STALBERT LEAMNApproved
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsPrimary ContactUpdateGroup Change RequestBuda, Alicia Operations Manager Mayo Clinic 5072933251Lemin, Matt Program Manager Mayo Clinic Health System 50729338534/22/2025 11:19 AM
ContactsSigned ByInsertNew Registration Paul, Travis C. Regional Chair of Administration SWMN Mayo Clinic 60839297164/22/2025 10:02 AM
Details340B IDUpdateNew Registration DSH240043P4/22/2025 10:02 AM
DetailsEntity SubnameUpdateNew RegistrationMAYO CLINIC HEALTH SYSTEM ALBERT LEMAYO CLINIC HEALTH SYSTEM ALBERT LE - Allergy4/22/2025 10:02 AM
DatesParticipating Approval DateUpdateNew Registration 4/22/2025 10:02:43 AM4/22/2025 10:02 AM
DetailsStateUpdateNew RegistrationPendingApproved4/22/2025 10:02 AM
DatesSigned By DateUpdateNew Registration 4/15/2025 8:12:05 AM4/22/2025 10:02 AM
DatesStart DateUpdateNew Registration 7/1/2025 12:00:00 AM4/22/2025 10:02 AM
AddressesMain AddressInsertNew Registration  404 W FOUNTAIN ST ALBERT LEA, MN 56007-24374/14/2025 4:21 PM
AddressesShipping AddressInsertNew Registration MAYO CLINIC HEALTH SYSTEM-ALBERT LEA AND AUSTIN 1000 1ST DRIVE NW AUSTIN, MN 559124/14/2025 4:21 PM
AddressesShipping AddressInsertNew Registration MCHS ALBERT LEA MAYO CLINIC HEALTH SYSTEM PHARMACY 404 W FOUNTAIN STREET ALBERT LEA, MN 560074/14/2025 4:21 PM
AddressesShipping AddressInsertNew Registration MCHS Albert Lea Austin Hospital Pharmacy 1000 1st Drive NW Austin, MN 559124/14/2025 4:21 PM
AddressesShipping AddressInsertNew Registration MCHS Albert Lea Albert Lea Outpatient Pharmacy 404 W Fountain Street Albert Lea, MN 560074/14/2025 4:21 PM
AddressesShipping AddressInsertNew Registration MCHS Albert Lea Albert Lea Hospital Pharmacy 404 W Fountain Street Albert Lea, MN 560074/14/2025 4:21 PM
AddressesShipping AddressInsertNew Registration MCHS Albert Lea Austin Outpatient Pharmacy 1000 1st Drive NW Austin, MN 559124/14/2025 4:21 PM
ContactsPrimary ContactInsertNew Registration Buda, Alicia Operations Manager Mayo Clinic 50729332514/14/2025 4:21 PM
ContactsAuthorizing OfficialInsertNew Registration Paul, Travis C. Regional Chair of Administration SWMN Mayo Clinic 60839297164/14/2025 4:21 PM
DetailsAssistance Received From DateInsertNew Registration  4/14/2025 4:21 PM
DetailsAssistance Received To DateInsertNew Registration  4/14/2025 4:21 PM
DetailsLast Recertification DateInsertNew Registration  4/14/2025 4:21 PM
DetailsGrant NumberInsertNew Registration  4/14/2025 4:21 PM
Details340B IDInsertNew Registration  4/14/2025 4:21 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/14/2025 4:21 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/14/2025 4:21 PM
DetailsMedicare Provider NumberInsertNew Registration 2400434/14/2025 4:21 PM
DetailsEntity NameInsertNew Registration MAYO CLNIC HLTH SYS-ALBRT LEA AUSTIN4/14/2025 4:21 PM
DetailsNOFO NumberInsertNew Registration  4/14/2025 4:21 PM
DetailsProgram CodeInsertNew Registration DSH4/14/2025 4:21 PM
DetailsEntity SubnameInsertNew Registration MAYO CLINIC HEALTH SYSTEM ALBERT LE4/14/2025 4:21 PM
DatesParticipating Approval DateInsertNew Registration  4/14/2025 4:21 PM
DetailsStateInsertNew Registration Pending4/14/2025 4:21 PM
DatesRegistration DateInsertNew Registration 4/14/2025 4:21:27 PM4/14/2025 4:21 PM
DatesSigned By DateInsertNew Registration  4/14/2025 4:21 PM
DatesStart DateInsertNew Registration  4/14/2025 4:21 PM
TerminationsTermination CommentsInsertNew Registration  4/14/2025 4:21 PM
TerminationsTermination DateInsertNew Registration  4/14/2025 4:21 PM
TerminationsTermination Effective DateInsertNew Registration  4/14/2025 4:21 PM
TerminationsTermination ReasonInsertNew Registration  4/14/2025 4:21 PM