Covered Entity Details

DSH240063A HEALTHEAST ST JOSEPHS HOSPITAL (Terminated) - information as of 5/13/2025 10:52:59 PM

Main Details

Name

HEALTHEAST ST JOSEPHS HOSPITAL

Subdivision Name

HealthEast Hospice

Type

Disproportionate Share Hospital

Rural

340B ID

DSH240063A

Medicare Provider Number

240063

Outpatient Facility Provider Number

241504

Additional Details

Current Program Status

Terminated

Registration Date

7/10/2014

Participating Start Date

10/1/2014

Participating Approval Date

9/15/2014

Last Recertification Date

9/3/2015

Termination Date
Termination Reason

4/1/2016
Site closure

Contacts

Authorizing Official

Fairview Health Services
Trudi Noel Trysla, Chief Legal Officer
(612) 672-6382

Primary Contact

HealthEast Care System
Dean Huska, Director - Pharmacy Contracting
(651) 324-9440

Addresses

Street Address

45 West 10th Street
St. Paul, MN 55102

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?
Yes

State	Medicaid Number	NPI Number
MN	714555100
		1114948833

Shipping Addresses

Same as Street Address

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
DSH240063A	Child	DSH	HEALTHEAST ST JOSEPHS HOSPITAL	HealthEast Hospice	45 West 10th Street	St. Paul	MN	Terminated
DSH240063B	Child	DSH	HEALTHEAST ST JOSEPHS HOSPITAL	HealthEast Hospice	1700 University Avenue West	St. Paul	MN	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Profile Change Request	Huska, Dean Director - Pharmacy Contracting HealthEast Care System 6512323234	Huska, Dean Director - Pharmacy Contracting HealthEast Care System 6513249440	4/18/2024 3:21 PM
Contacts	Primary Contact	Update	Profile Change Request	Huska, Dean Corporate Director - Pharmacy Contracting HealthEast Care System 6512323234	Huska, Dean Director - Pharmacy Contracting HealthEast Care System 6512323234	8/21/2019 4:19 PM
Contacts	Authorizing Official	Update	Change Request	Barr, Catherine SVP/COO HealthEast Care System 6512322185	Trysla, Trudi Noel Chief Legal Officer Fairview Health Services 6126726382	4/4/2019 9:21 AM
Contacts	Authorizing Official	Update	AO Change Request	Barr, Catherine SVP/COO 6512322185	Fromm, Daniel M. Sr. VP and CFO, Fairview Health Services Fairview Health Services 6126724976	10/25/2017 1:26 PM
Contacts	Authorizing Official	Update	New Registration	Fromm, Daniel M. Sr. VP and CFO, Fairview Health Services Fairview Health Services 6126724976	Barr, Catherine SVP/COO HealthEast Care System 6512322185	10/13/2017 5:56 PM
Contacts	Primary Contact	Update		Huska, Dean Corporate Director - Pharmacy Contracting 6512323234	Huska, Dean Corporate Director - Pharmacy Contracting HealthEast Care System 6512323234	10/12/2017 5:01 PM
Contacts	Authorizing Official	Update		Davenport, Doug Senior VP/Chief Financial Officer 6512322250	Barr, Catherine SVP/COO 6512322185	9/11/2017 3:29 PM
Contacts	Authorizing Official	Insert			Davenport, Doug Senior VP/Chief Financial Officer 6512322250	6/1/2017 1:44 PM
Contacts	Signed By	Insert			Davenport, Doug Senior VP/Chief Financial Officer 6512322250	6/1/2017 1:44 PM
Contacts	Primary Contact	Insert			Huska, Dean Corporate Director - Pharmacy Contracting 6512323234	6/1/2017 1:44 PM
Addresses	Main Address	Insert			45 West 10th Street St. Paul, MN 55102	3/2/2016 9:56 AM
Dates	Last Date That 340B Drugs Purchased	Update			3/31/2016 12:00:00 AM	3/2/2016 9:56 AM
Details	State	Update		Active	Terminated	3/2/2016 9:56 AM
Terminations	Termination Comments	Update			HealthEast Hospice remains eligible and is listed on cost report, however as we are not purchasing drugs for them, we will remove them from the database for the present.	3/2/2016 9:56 AM
Terminations	Termination Date	Update			4/1/2016 12:00:00 AM	3/2/2016 9:56 AM
Terminations	Termination Effective Date	Update			4/1/2016 12:00:00 AM	3/2/2016 9:56 AM
Terminations	Termination Reason	Update			Site closure	3/2/2016 9:56 AM
Details	Last Recertification Date	Update			9/3/2015 12:00:00 AM	9/3/2015 4:46 PM
Details	Entity Subname	Update		HealthEast Hospice / HealthEast Hospice	HealthEast Hospice	12/31/2014 3:51 PM
Details	Entity Subname	Update		HealthEast Hospice	HealthEast Hospice / HealthEast Hospice	12/19/2014 2:16 PM
Details	340B ID	Update		DSH240063	DSH240063A	9/15/2014 11:34 AM
Details	Entity Subname	Update			HealthEast Hospice	9/15/2014 11:34 AM
Dates	Participating Approval Date	Update			9/15/2014 12:00:00 AM	9/15/2014 11:34 AM
Details	State	Update		Pending	Active	9/15/2014 11:34 AM
Dates	Start Date	Update			10/1/2014 12:00:00 AM	9/15/2014 11:34 AM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_45127	DSH240063	9/8/2014 1:15 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_45127	7/10/2014 5:49 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/10/2014 5:48 PM
Medicaid Billing	Medicaid: Number	Insert			714555100	7/10/2014 5:48 PM
Medicaid Billing	Medicaid: State	Insert			MN	7/10/2014 5:48 PM
Medicaid Billing	NPI: Number	Insert			1114948833	7/10/2014 5:48 PM
Details	Last Recertification Date	Insert				7/10/2014 5:48 PM
Details	Grant Number	Insert				7/10/2014 5:48 PM
Details	340B ID	Insert				7/10/2014 5:48 PM
Details	Is Authorizing Official EHB Data	Insert				7/10/2014 5:48 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/10/2014 5:48 PM
Details	Medicare Provider Number	Insert			240063	7/10/2014 5:48 PM
Details	Entity Name	Insert			HEALTHEAST ST JOSEPHS HOSPITAL	7/10/2014 5:48 PM
Details	Program Code	Insert			DSH	7/10/2014 5:48 PM
Details	Entity Subname	Insert				7/10/2014 5:48 PM
Dates	Participating Approval Date	Insert				7/10/2014 5:48 PM
Details	State	Insert			Pending	7/10/2014 5:48 PM
Dates	Registration Date	Insert			7/10/2014 12:00:00 AM	7/10/2014 5:48 PM
Dates	Signed By Date	Insert			7/10/2014 12:00:00 AM	7/10/2014 5:48 PM
Dates	Start Date	Insert				7/10/2014 5:48 PM
Terminations	Termination Comments	Insert				7/10/2014 5:48 PM
Terminations	Termination Date	Insert				7/10/2014 5:48 PM
Terminations	Termination Effective Date	Insert				7/10/2014 5:48 PM
Terminations	Termination Reason	Insert				7/10/2014 5:48 PM