Covered Entity Details

CAH521313-00 ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. - DBA ASPIRUS TOMAHAWK HOSPITAL (Terminated) - information as of 5/11/2025 11:48:24 PM

Main Details

Name

ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. - DBA ASPIRUS TOMAHAWK HOSPITAL

Subdivision Name

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH521313-00

Medicare Provider Number

521313

Additional Details

Current Program Status

Terminated

Registration Date

2/28/2012

Participating Start Date

4/1/2012

Participating Approval Date

3/15/2012

Last Recertification Date

9/1/2021

Termination Date
Termination Reason

7/1/2022
Business decision by the Covered Entity

Contacts

Authorizing Official

Aspirus, Inc
PAT TINCHER, Vice President-Finance, Regional Markets
(715) 847-2425

Primary Contact

Aspirus, Inc.
Stacy Kolz, 340B Pharmacy Program Supervisor
(715) 610-4236

Addresses

Street Address

401 West Mohawk Drive
Tomahawk, WI 54487

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Shipping Address 1

ASPIRUS RHINELANDER HOSPITAL
2251 North Shore Drive
Rhinelander, WI 54501

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ASCENSION WISCONSIN PHARMACY, INC	DBA ASCENSION RX 701	1901 WESTWOOD CENTER BLVD	WAUSAU	WI	54401	01/15/2021	01/15/2021	07/01/2022	07/01/2022
Contract Detail	ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS	DBA: ASPIRUS PHARMACY - WESTWOOD WAUSAU	1901 WESTWOOD CENTER BLVD	WAUSAU	WI	54401	10/13/2021	01/01/2022	07/01/2022	07/01/2022
Contract Detail	ASPIRUS STANLEY HOSPITAL	1120 PINE ST		STANLEY	WI	54768	07/13/2016	10/01/2016	11/30/2017	12/11/2017
Contract Detail	SAINT JOSEPH'S HOSP OTPA PHARM	DBA ASCENSION WISCONSIN PHARMACY #701	1901 WESTWOOD CENTER BLVD	WAUSAU	WI	54401	04/09/2013	07/01/2013	01/14/2021	02/26/2021
Contract Detail	SHOPKO PHARMACY #2170	2200 LINCOLN STREET		RHINELANDER	WI	54501	07/16/2014	10/01/2014	01/31/2019	05/13/2019
Contract Detail	SHOPKO PHARMACY #2792	79 HOMETOWN DR.		TOMAHAWK	WI	54487	04/16/2014	07/01/2014	01/31/2019	05/13/2019
Contract Detail	TOMAHAWK PHARMACY, LLC	844 N 4TH ST		TOMAHAWK	WI	54487-2127	07/14/2014	10/01/2014	10/31/2019	12/16/2019

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH521313-01	Child	CAH	Ascension Sacred Heart - St. Mary's Hospitals, Inc. - DBA Ascension Sacred Heart Hospital	MMG-Tomahawk	401 West Mohawk Drive	Tomahawk	WI	Terminated
CAH521313-02	Child	CAH	Ascension Sacred Heart - St. Mary's Hospitals, Inc. - DBA Ascension Sacred Heart Hospital	Crandon Radiology - Radiology	400 West Glen St.	Crandon	WI	Terminated
CAH521313-03	Child	CAH	Ascension Sacred Heart - St. Mary's Hospitals, Inc. - DBA Ascension Sacred Heart Hospital	Rural Health Clinic - CMG Family Practice - Family Practice	400 West Glen St.	Crandon	WI	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	7/1/2022 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		11/30/2021 12:00:00 AM	6/30/2022 8:42 AM
Details	State	Update	Termination Request	Active	To Be Terminated	6/30/2022 8:42 AM
Terminations	Termination Date	Update	Termination Request		7/1/2022 12:00:00 AM	6/30/2022 8:42 AM
Terminations	Termination Effective Date	Update	Termination Request		12/1/2021 12:00:00 AM	6/30/2022 8:42 AM
Terminations	Termination Reason	Update	Termination Request		Business decision by the Covered Entity	6/30/2022 8:42 AM
Contacts	Primary Contact	Update	Profile Change Request	Kolz, Stacy System 340B Coordinator Aspirus, Inc. 7156104236	Kolz, Stacy 340B Pharmacy Program Supervisor Aspirus, Inc. 7156104236	1/28/2022 1:07 PM
Addresses	Shipping Address	Update	Change Request	Ministry Saint Mary's Hospital 2251 North Shore Drive Rhinelander, WI 54501	ASPIRUS RHINELANDER HOSPITAL 2251 North Shore Drive Rhinelander, WI 54501	12/30/2021 6:16 AM
Details	Entity Name	Update	Change Request	Ascension Sacred Heart - St. Mary's Hospitals, Inc. - DBA Ascension Sacred Heart Hospital	ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. - DBA ASPIRUS TOMAHAWK HOSPITAL	12/30/2021 6:16 AM
Details	Last Recertification Date	Update	Recertification	8/18/2020 7:47:45 AM	9/1/2021 8:24:26 PM	9/1/2021 8:24 PM
Contacts	Authorizing Official	Update	Change Request	Oungst, Laurie Chief Administrative Officer Ascension Eagle River Hospital 7153568560	TINCHER, PAT Vice President-Finance, Regional Markets Aspirus, Inc 7158472425	8/17/2021 8:14 AM
Contacts	Primary Contact	Update	Change Request	Pearce, Bryan 340B Program Director - North Region Ascension WI 7154790312	Kolz, Stacy System 340B Coordinator Aspirus, Inc. 7156104236	8/17/2021 8:14 AM
Details	Entity Name	Update	Change Request	Ascension Sacred Heart - St. Mary's Hospitals, Inc.	Ascension Sacred Heart - St. Mary's Hospitals, Inc. - DBA Ascension Sacred Heart Hospital	1/7/2021 6:48 AM
Details	Last Recertification Date	Update	Recertification	8/26/2019 10:38:37 AM	8/18/2020 7:47:45 AM	8/18/2020 7:47 AM
Contacts	Authorizing Official	Update	Change Request	Theiler, Teresa Chief Administrative Officer St Mary Admin Ministry Health Care 7153612177	Oungst, Laurie Chief Administrative Officer Ascension Eagle River Hospital 7153568560	9/12/2019 2:35 PM
Details	Last Recertification Date	Update	Recertification	8/21/2018 5:45:50 PM	8/26/2019 10:38:37 AM	8/26/2019 10:38 AM
Contacts	Authorizing Official	Update	Change Request	Anderson, Sandra Regional Vice President - Northern Region & Hospital President Ascension 7153612007	Theiler, Teresa Chief Administrative Officer St Mary Admin Ministry Health Care 7153612177	7/9/2019 6:49 AM
Details	Last Recertification Date	Update	Recertification	11/15/2017 2:48:02 PM	8/21/2018 5:45:50 PM	8/21/2018 5:45 PM
Details	Entity Name	Update	Change Request	Ministry Sacred Heart Hospital	Ascension Sacred Heart - St. Mary's Hospitals, Inc.	12/14/2017 10:33 AM
Contacts	Authorizing Official	Update	Change Request	Zenk, Ann Regional Vice President-Northern Region 7153612177	Anderson, Sandra Regional Vice President - Northern Region & Hospital President Ascension 7153612007	11/30/2017 10:50 AM
Contacts	Primary Contact	Update	Recertification	Jamison, Brad Pharmacy Manager 7153612650	Pearce, Bryan 340B Program Director - North Region Ascension WI 7154790312	11/15/2017 2:48 PM
Details	Last Recertification Date	Update	Recertification	8/18/2016 12:00:00 AM	11/15/2017 2:48:02 PM	11/15/2017 2:48 PM
Contacts	Signed By	Insert			Erickson, Bill Vice President-Operations 7153612012	8/18/2016 2:51 PM
Addresses	Main Address	Insert			401 West Mohawk Drive Tomahawk, WI 54487	8/18/2016 2:32 PM
Details	Last Recertification Date	Update		8/19/2015 12:00:00 AM	8/18/2016 12:00:00 AM	8/18/2016 2:32 PM
Addresses	Shipping Address	Insert			Ministry Saint Mary's Hospital 2251 North Shore Drive Rhinelander, WI 54501	8/26/2015 1:21 PM
Contacts	Authorizing Official	Insert			Zenk, Ann Regional Vice President-Northern Region 7153612177	8/19/2015 11:10 AM
Details	Last Recertification Date	Update		8/7/2014 12:00:00 AM	8/19/2015 12:00:00 AM	8/19/2015 10:49 AM
Contacts	Primary Contact	Insert			Jamison, Brad Pharmacy Manager 7153612650	9/8/2014 7:46 AM
Details	Last Recertification Date	Update		8/28/2013 12:00:00 AM	8/7/2014 12:00:00 AM	8/7/2014 1:25 PM
Details	Last Recertification Date	Update		8/28/2013 12:05:00 PM	8/28/2013 12:00:00 AM	1/9/2014 1:59 PM
Details	Last Recertification Date	Update			8/28/2013 12:05:00 PM	8/28/2013 12:05 PM
Details	340B ID	Update		IS-EMG-CAH521313-00	CAH521313-00	3/15/2012 5:22 AM
Dates	Participating Approval Date	Update			3/15/2012 12:00:00 AM	3/15/2012 5:22 AM
Details	State	Update		Pending	Active	3/15/2012 5:22 AM
Dates	Start Date	Update			4/1/2012 12:00:00 AM	3/15/2012 5:22 AM
Details	340B ID	Update		EMG022812A	IS-EMG-CAH521313-00	3/12/2012 10:39 AM
Details	340B ID	Update		ONLINE_REG	EMG022812A	2/28/2012 5:37 PM
Details	Last Recertification Date	Insert				2/28/2012 2:50 PM
Details	Grant Number	Insert				2/28/2012 2:50 PM
Details	340B ID	Insert			ONLINE_REG	2/28/2012 2:50 PM
Details	Is Authorizing Official EHB Data	Insert				2/28/2012 2:50 PM
Dates	Last Date That 340B Drugs Purchased	Insert				2/28/2012 2:50 PM
Details	Medicare Provider Number	Insert			521313	2/28/2012 2:50 PM
Details	Entity Name	Insert			Ministry Sacred Heart Hospital	2/28/2012 2:50 PM
Details	Program Code	Insert			CAH	2/28/2012 2:50 PM
Details	Entity Subname	Insert				2/28/2012 2:50 PM
Dates	Participating Approval Date	Insert				2/28/2012 2:50 PM
Details	State	Insert			Pending	2/28/2012 2:50 PM
Dates	Registration Date	Insert			2/28/2012 12:00:00 AM	2/28/2012 2:50 PM
Dates	Signed By Date	Insert			2/28/2012 12:00:00 AM	2/28/2012 2:50 PM
Dates	Start Date	Insert				2/28/2012 2:50 PM
Terminations	Termination Comments	Insert				2/28/2012 2:50 PM
Terminations	Termination Date	Insert				2/28/2012 2:50 PM
Terminations	Termination Effective Date	Insert				2/28/2012 2:50 PM
Terminations	Termination Reason	Insert				2/28/2012 2:50 PM