Covered Entity Details

CAH231318-07 ASPIRUS IRON RIVER HOSPITAL & CLINICS (Active) - information as of 5/6/2025 12:02:31 AM

Main Details

Name

ASPIRUS IRON RIVER HOSPITAL & CLINICS

Subdivision Name

ASPIRUS IRON RIVER CLINIC - FP

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH231318-07

Medicare Provider Number

231318

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/11/2017

Participating Start Date

1/1/2018

Participating Approval Date

10/12/2017

Last Recertification Date

8/22/2024

Contacts

Authorizing Official

Aspirus, Inc.
Jerry Yang, SVP & Chief Financial Officer, Fiscal Services
(715) 847-2526

Primary Contact

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

Addresses

Street Address

814 SOUTH ICE LAKE ROAD
IRON RIVER, MI 49935

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

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
CAH231318-01	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS ICE LAKE CLINIC	1300 WEST ICE LAKE	IRON RIVER	MI	Terminated
CAH231318-02	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS RIVERSIDE CLINIC	927 RIVERSIDE PLAZA	IRON RIVER	MI	Terminated
CAH231318-03	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS GENESEE CLINIC	229 WEST GENESEE	IRON RIVER	MI	Terminated
CAH231318-04	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS CRYSTAL FALLS CLINIC	1328 HIGHWAY US 2	CRYSTAL FALLS	MI	Active
CAH231318-05	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS SURGICAL ASSOCIATES	1500 WEST ICE LAKE ROAD	IRON RIVER	MI	Terminated
CAH231318-06	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS DIALYSIS - CRYSTAL FALLS - DIALYSIS	1328 US HWY 2	CRYSTAL FALLS	MI	Terminated
CAH231318-07	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS IRON RIVER CLINIC - FP	814 SOUTH ICE LAKE ROAD	IRON RIVER	MI	Active
CAH231318-08	Child	CAH	ASPIRUS IRON RIVER HOSPITAL & CLINICS	ASPIRUS CRYSTAL FALLS - RHC - PRIMARY CARE	1328 HIGHWAY US 2	CRYSTAL FALLS	MI	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Change Request	TINCHER, PAT Vice President-Finance, Regional Markets Aspirus, Inc 7158472425	Yang, Jerry SVP & Chief Financial Officer, Fiscal Services Aspirus, Inc. 7158472526	1/3/2025 11:45 AM
Details	Last Recertification Date	Update	Recertification	8/24/2023 8:16:42 AM	8/22/2024 7:52:17 AM	8/22/2024 7:52 AM
Details	Last Recertification Date	Update	Recertification	9/6/2022 8:10:43 AM	8/24/2023 8:16:42 AM	8/24/2023 8:16 AM
Details	Last Recertification Date	Update	Recertification	8/27/2021 10:13:58 AM	9/6/2022 8:10:43 AM	9/6/2022 8:10 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
Contacts	Primary Contact	Update	Recertification	FRITSCHE, JOHN 340b Coordinator Aspirus Iron River Hospital & Clinics 9062650449	Kolz, Stacy System 340B Coordinator Aspirus, Inc. 7156104236	8/27/2021 10:13 AM
Details	Last Recertification Date	Update	Recertification	9/9/2020 6:12:21 PM	8/27/2021 10:13:58 AM	8/27/2021 10:13 AM
Details	Last Recertification Date	Update	Recertification	8/28/2019 9:38:06 AM	9/9/2020 6:12:21 PM	9/9/2020 6:12 PM
Contacts	Authorizing Official	Update	Profile Change Request	TINCHER, PAT CFO Aspirus Langlade Hospital 7156239215	TINCHER, PAT Vice President-Finance, Regional Markets Aspirus, Inc 7158472425	8/20/2020 9:30 AM
Contacts	Authorizing Official	Update	Change Request	DOBSON, GLENN E CFO Aspirus Iron River 9062650436	TINCHER, PAT CFO Aspirus Langlade Hospital 7156239215	5/14/2020 8:59 AM
Details	Last Recertification Date	Update	Recertification	8/29/2018 2:37:42 PM	8/28/2019 9:38:06 AM	8/28/2019 9:38 AM
Details	Last Recertification Date	Update	Recertification		8/29/2018 2:37:42 PM	8/29/2018 2:37 PM
Details	State	Update		Approved	Active	1/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		DOBSON, GLENN E CFO Aspirus Iron River 9062650436	10/12/2017 1:52 PM
Details	340B ID	Update	New Registration		CAH231318-07	10/12/2017 1:52 PM
Details	Entity Subname	Update	New Registration	ASPIRUS IRON RIVER CLINIC	ASPIRUS IRON RIVER CLINIC - FP	10/12/2017 1:52 PM
Dates	Participating Approval Date	Update	New Registration		10/12/2017 1:52:03 PM	10/12/2017 1:52 PM
Details	State	Update	New Registration	Pending	Approved	10/12/2017 1:52 PM
Dates	Signed By Date	Update	New Registration		10/11/2017 10:20:31 AM	10/12/2017 1:52 PM
Dates	Start Date	Update	New Registration		1/1/2018 12:00:00 AM	10/12/2017 1:52 PM
Addresses	Main Address	Insert	New Registration		814 SOUTH ICE LAKE ROAD IRON RIVER, MI 49935	10/11/2017 10:20 AM
Contacts	Authorizing Official	Insert	New Registration		DOBSON, GLENN E CFO Aspirus Iron River 9062650436	10/11/2017 10:20 AM
Contacts	Primary Contact	Insert	New Registration		FRITSCHE, JOHN 340b Coordinator Aspirus Iron River Hospital & Clinics 9062650449	10/11/2017 10:20 AM
Details	Last Recertification Date	Insert	New Registration			10/11/2017 10:20 AM
Details	Grant Number	Insert	New Registration			10/11/2017 10:20 AM
Details	340B ID	Insert	New Registration			10/11/2017 10:20 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/11/2017 10:20 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/11/2017 10:20 AM
Details	Medicare Provider Number	Insert	New Registration		231318	10/11/2017 10:20 AM
Details	Entity Name	Insert	New Registration		ASPIRUS IRON RIVER HOSPITAL & CLINICS	10/11/2017 10:20 AM
Details	Program Code	Insert	New Registration		CAH	10/11/2017 10:20 AM
Details	Entity Subname	Insert	New Registration		ASPIRUS IRON RIVER CLINIC	10/11/2017 10:20 AM
Dates	Participating Approval Date	Insert	New Registration			10/11/2017 10:20 AM
Details	State	Insert	New Registration		Pending	10/11/2017 10:20 AM
Dates	Registration Date	Insert	New Registration		10/11/2017 10:20:28 AM	10/11/2017 10:20 AM
Dates	Signed By Date	Insert	New Registration			10/11/2017 10:20 AM
Dates	Start Date	Insert	New Registration			10/11/2017 10:20 AM
Terminations	Termination Comments	Insert	New Registration			10/11/2017 10:20 AM
Terminations	Termination Date	Insert	New Registration			10/11/2017 10:20 AM
Terminations	Termination Effective Date	Insert	New Registration			10/11/2017 10:20 AM
Terminations	Termination Reason	Insert	New Registration			10/11/2017 10:20 AM