Covered Entity Details

DSH240106L REGIONS HOSPITAL (Active) - information as of 5/27/2025 11:40:29 PM

Main Details

Name

REGIONS HOSPITAL

Subdivision Name

SLEEP HEALTH CENTER

Type

Disproportionate Share Hospital

Rural

340B ID

DSH240106L

Medicare Provider Number

240106

Outpatient Facility Provider Number

240106

Additional Details

Current Program Status

Active

Registration Date

7/9/2014

Participating Start Date

10/1/2014

Participating Approval Date

9/3/2014

Last Recertification Date

8/21/2024

Contacts

Authorizing Official

Regions Hospital
John M Clark, VP Finance
(651) 254-0900

Primary Contact

Regions Hospital
Tanya Y Barnhart, Director, Pharmaceutical Services
(651) 254-9560

Addresses

Street Address

2688 MAPLEWOOD DR
MAPLEWOOD, MN 55109-1021

Billing Address

Regions Hospital
640 Jackson St
St Paul, MN 55101

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?
Yes

State	Medicaid Number	NPI Number
MN	422247400	1629006457,1013951748
WI	11005600	1629006457,1013951748

Shipping Addresses

Shipping Address 1

Regions Hospital
640 Jackson St
St Paul, MN 55101

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH240106A	Child	DSH	REGIONS HOSPITAL	REGIONS OUTPATIENT SERVICES	401 PHALEN BLVD	ST. PAUL	MN	Terminated
DSH240106B	Child	DSH	REGIONS HOSPITAL	REGIONS OUTPATIENT SERVICES	435 PHALEN BLVD	ST. PAUL	MN	Terminated
DSH240106C	Child	DSH	REGIONS HOSPITAL	HSC Dexascan	401 Phalen Blvd	St. Paul	MN	Terminated
DSH240106D	Child	DSH	REGIONS HOSPITAL	HSC Ultrasound	401 Phalen Blvd	Saint Paul	MN	Terminated
DSH240106E	Child	DSH	REGIONS HOSPITAL	HSC CT Scan	401 Phalen Blvd	Saint Paul	MN	Terminated
DSH240106F	Child	DSH	REGIONS HOSPITAL	HSC 401 Magnetic Resonance Imaging	401 Phalen Blvd	Saint Paul	MN	Active
DSH240106G	Child	DSH	REGIONS HOSPITAL	HSC PET Scan	401 Phalen Blvd	Saint Paul	MN	Terminated
DSH240106J	Child	DSH	REGIONS HOSPITAL	HSC Same Day Surgery	435 Phalen Blvd	St. Paul	MN	Active
DSH240106K	Child	DSH	REGIONS HOSPITAL	HSC GI Clinic/Services	435 Phalen Blvd	Saint Paul	MN	Active
DSH240106L	Child	DSH	REGIONS HOSPITAL	SLEEP HEALTH CENTER	2688 MAPLEWOOD DR	MAPLEWOOD	MN	Active
DSH240106M	Child	DSH	REGIONS HOSPITAL	ADAP (ALCOHOL DRUG ABUSE PROGRAM)	445 ETNA STREET	ST PAUL	MN	Terminated
DSH240106N	Child	DSH	REGIONS HOSPITAL	CARDIOPULMONARY REHAB	2575 UNIVERSITY AVE STE 140 WESTGATE	ST PAUL	MN	Terminated
DSH240106P	Child	DSH	REGIONS HOSPITAL	HSC HAND THERAPY	401 PHALEN BLVD	ST PAUL	MN	Terminated
DSH240106Q	Child	DSH	REGIONS HOSPITAL	DIGESTIVE CARE ENDOSCOPY PROCEDURES	435 PHALEN BLVD	ST PAUL	MN	Active
DSH240106R	Child	DSH	REGIONS HOSPITAL	Digestive Clinic	435 Phalen Blvd	Saint Paul	MN	Terminated
DSH240106S	Child	DSH	REGIONS HOSPITAL	PHYSICAL THERAPY	1710 Suburban Square	SAINT PAUL	MN	Terminated
DSH240106T	Child	DSH	REGIONS HOSPITAL	REGIONS HOSPITAL REHABILITATION INS	8425 SEASONS PKWY STE 103	WOODBURY	MN	Terminated
DSH240106U	Child	DSH	REGIONS HOSPITAL	RIVERSIDE HAND AND PHYSICAL THERAPY	2220 RIVERSIDE AVENUE	MINNEAPOLIS	MN	Terminated
DSH240106V	Child	DSH	REGIONS HOSPITAL	REGIONS HOSPITAL - NEUROSCIENCE CENTER RADIOLOGY	295 PHALEN BLVD	ST. PAUL	MN	Active
DSH240106W	Child	DSH	REGIONS HOSPITAL	REGIONS HOSPITAL - Med Mgmt	435 PHALEN BLVD	SAINT PAUL	MN	Active
DSH240106X	Child	DSH	REGIONS HOSPITAL	REGIONS HOSPITAL - Infusion Clinic - Coon Rapids	11850 BLACKFOOT ST NW	COON RAPIDS	MN	Active
DSH240106Y	Child	DSH	REGIONS HOSPITAL	REGIONS HOSPITAL - Cancer Clinic - Coon Rapids	11850 BLACKFOOT ST NW	COON RAPIDS	MN	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/23/2023 8:27:16 AM	8/21/2024 12:29:04 AM	8/21/2024 12:29 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1013951748	12/5/2023 9:23 AM
Medicaid Billing	NPI: State	Insert	Change Request		WI	12/5/2023 9:23 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1013951748	12/5/2023 9:23 AM
Medicaid Billing	NPI: State	Insert	Change Request		MN	12/5/2023 9:23 AM
Details	Last Recertification Date	Update	Recertification	8/30/2022 3:51:23 PM	8/23/2023 8:27:16 AM	8/23/2023 8:27 AM
Details	Last Recertification Date	Update	Recertification	8/18/2021 9:52:17 AM	8/30/2022 3:51:23 PM	8/30/2022 3:51 PM
Addresses	Billing Address	Insert	Change Request		Regions Hospital 640 Jackson St St Paul, MN 55101	9/21/2021 6:46 AM
Addresses	Shipping Address	Insert	Change Request		Regions Hospital 640 Jackson St St Paul, MN 55101	9/21/2021 6:46 AM
Contacts	Authorizing Official	Update	Change Request	CONRAD, HEIDI CFO Regions Hospital 6512540900	Clark, John M VP Finance Regions Hospital 6512540900	9/16/2021 12:45 PM
Details	Last Recertification Date	Update	Recertification	8/25/2020 3:13:23 PM	8/18/2021 9:52:17 AM	8/18/2021 9:52 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1629006457	8/25/2020 3:13 PM
Medicaid Billing	NPI: State	Insert	Recertification		WI	8/25/2020 3:13 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1629006457	8/25/2020 3:13 PM
Medicaid Billing	NPI: State	Insert	Recertification		MN	8/25/2020 3:13 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1629006457 ( )		8/25/2020 3:13 PM
Details	Last Recertification Date	Update	Recertification	8/26/2019 10:16:29 AM	8/25/2020 3:13:23 PM	8/25/2020 3:13 PM
Contacts	Primary Contact	Update	Profile Change Request	Barnhart, Tanya Y Director, Pharmaceutical Services Regions Hospital 6512540869	Barnhart, Tanya Y Director, Pharmaceutical Services Regions Hospital 6512549560	6/17/2020 10:40 AM
Contacts	Primary Contact	Update	Change Request	Harvey, Craig L. Director of Pharmacy Svcs Regions Hospital 6512549560	Barnhart, Tanya Y Director, Pharmaceutical Services Regions Hospital 6512540869	6/8/2020 11:03 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/23/2019 1:47 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		422247400	12/23/2019 1:47 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MN	12/23/2019 1:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/23/2019 1:47 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		11005600	12/23/2019 1:47 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WI	12/23/2019 1:47 PM
Details	Last Recertification Date	Update	Recertification	8/30/2018 11:07:22 AM	8/26/2019 10:16:29 AM	8/26/2019 10:16 AM
Details	Last Recertification Date	Update	Recertification	11/9/2017 3:22:12 PM	8/30/2018 11:07:22 AM	8/30/2018 11:07 AM
Contacts	Primary Contact	Update	Change Request	Velleux, Eric Manager, Reimbursement and Government Reporting Regions Hospital 6512541827	Harvey, Craig L. Director of Pharmacy Svcs Regions Hospital 6512549560	6/27/2018 8:57 AM
Contacts	Primary Contact	Insert	Recertification		Velleux, Eric Manager, Reimbursement and Government Reporting Regions Hospital 6512541827	11/9/2017 3:22 PM
Details	Last Recertification Date	Update	Recertification	8/17/2016 12:00:00 AM	11/9/2017 3:22:12 PM	11/9/2017 3:22 PM
Contacts	Authorizing Official	Update		CONRAD, HEIDI CFO 6512540900	CONRAD, HEIDI CFO Regions Hospital 6512540900	10/19/2017 12:21 PM
Contacts	Signed By	Update		CONRAD, HEIDI CFO 6512540900	CONRAD, HEIDI CFO Regions Hospital 6512540900	10/19/2017 12:21 PM
Contacts	Authorizing Official	Insert			CONRAD, HEIDI CFO 6512540900	1/10/2017 11:02 AM
Contacts	Signed By	Insert			CONRAD, HEIDI CFO 6512540900	1/10/2017 11:02 AM
Addresses	Main Address	Insert			2688 MAPLEWOOD DR MAPLEWOOD, MN 55109-1021	8/17/2016 7:12 AM
Details	Last Recertification Date	Update		8/5/2015 12:00:00 AM	8/17/2016 12:00:00 AM	8/17/2016 7:12 AM
Details	Last Recertification Date	Update			8/5/2015 12:00:00 AM	8/7/2015 12:00 PM
Dates	Participating Approval Date	Update			9/3/2014 12:00:00 AM	9/3/2014 3:56 PM
Details	State	Update		Pending	Active	9/3/2014 3:56 PM
Dates	Start Date	Update			10/1/2014 12:00:00 AM	9/3/2014 3:56 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_44822	DSH240106L	8/28/2014 2:58 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_44822	7/9/2014 5:35 PM
Medicaid Billing	NPI: Number	Insert			1629006457	7/9/2014 5:35 PM
Details	Last Recertification Date	Insert				7/9/2014 5:35 PM
Details	Grant Number	Insert				7/9/2014 5:35 PM
Details	340B ID	Insert				7/9/2014 5:35 PM
Details	Is Authorizing Official EHB Data	Insert				7/9/2014 5:35 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/9/2014 5:35 PM
Details	Medicare Provider Number	Insert			240106	7/9/2014 5:35 PM
Details	Entity Name	Insert			REGIONS HOSPITAL	7/9/2014 5:35 PM
Details	Program Code	Insert			DSH	7/9/2014 5:35 PM
Details	Entity Subname	Insert			SLEEP HEALTH CENTER	7/9/2014 5:35 PM
Dates	Participating Approval Date	Insert				7/9/2014 5:35 PM
Details	State	Insert			Pending	7/9/2014 5:35 PM
Dates	Registration Date	Insert			7/9/2014 12:00:00 AM	7/9/2014 5:35 PM
Dates	Signed By Date	Insert			7/9/2014 12:00:00 AM	7/9/2014 5:35 PM
Dates	Start Date	Insert				7/9/2014 5:35 PM
Terminations	Termination Comments	Insert				7/9/2014 5:35 PM
Terminations	Termination Date	Insert				7/9/2014 5:35 PM
Terminations	Termination Effective Date	Insert				7/9/2014 5:35 PM
Terminations	Termination Reason	Insert				7/9/2014 5:35 PM