Covered Entity Details

SCH520019-07 ASPIRUS RHINELANDER HOSPITAL (Terminated) - information as of 5/30/2025 8:14:25 PM

Main Details

Name

ASPIRUS RHINELANDER HOSPITAL

Subdivision Name

ASPIRUS CRANDON CLINIC - CRANDON FAMILY PRACTICE

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH520019-07

Medicare Provider Number

520019

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

8/22/2024

Participating Start Date

10/1/2024

Participating Approval Date

8/29/2024

Last Recertification Date

Termination Date
Termination Reason

4/1/2025
Change of covered entity type

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

400 W GLEN STREET
CRANDON, WI 54520

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
Participated starting 4/1/2023; Terminated 10/1/2023; Reinstated 10/1/2024.	08/28/2024

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
SCH520019-01	Child	SCH	Ascension Sacred Heart - St. Mary's Hospitals, Inc. DBA Ascension Saint Mary's Hospital	Ministry Medical Group-Crandon	400 West Glen St.	Crandon	WI	Terminated
SCH520019-02	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS EAGLE RIVER CLINIC	930 East Wall St.	Eagle River	WI	Terminated
SCH520019-03	Child	SCH	Ascension Sacred Heart - St. Mary's Hospitals, Inc.	Ministry Medical Group-Laona	4876 Mill Street	Laona	WI	Terminated
SCH520019-04	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS RHINELANDER CLINIC - N SHORE DRIVE	2251 North Shore Dr.	Rhinelander	WI	Terminated
SCH520019-05	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS KOLLER BEHAVIORAL HEALTH CLINIC	1020 Kabel Avenue	Rhinelander	WI	Terminated
SCH520019-07	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS CRANDON CLINIC - CRANDON FAMILY PRACTICE	400 W GLEN STREET	CRANDON	WI	Terminated
SCH520019-08	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS TOMAHAWK CLINIC - TOMAHAWK FAMILY PRACTICE	401 W MOHAWK DR	TOMAHAWK	WI	Terminated
SCH520019-09	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS WOODRUFF CLINIC - MAPLE STREET - ASPIRUS WOODRUFF CLINIC - MAPLE STREET	240 MAPLE STREET	WOODRUFF	WI	Terminated
SCH520019-10	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS IOLA CLINIC - IOLA FAMILY PRACTICE	205 S MAIN STREET	IOLA	WI	Terminated
SCH520019-11	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS Wittenberg Clinic - Wittenberg	1660 Sue Alan Drive	Wittenberg	WI	Terminated
SCH520019-12	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE	824 ILLINOIS VE	STEVENS POINT	WI	Terminated
SCH520019-13	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - HOOVER ROAD - STEVENS POINT FAMILY PRACTICE HOOVER ROAD	3500 HOOVER RD	STEVENS POINT	WI	Terminated
SCH520019-14	Child	SCH	ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. - DBA ASPIRUS RHINELANDER HOSPITAL	ASPIRUS RHINELANDER CLINIC - N CHIPPEWA DRIVE - N CHIPPEWA DRIVE FAMILY PRACTICE	1630 N CHIPPEWA DRIVE	RHINELANDER	WI	Terminated
SCH520019-15	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS PLOVER CLINIC - PLOVER ROAD - PLOVER FAMILY PRACTICE - PLOVER ROAD	2401 PLOVER ROAD	PLOVER	WI	Terminated
SCH520019-16	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS AMHERST CLINIC - AMHERST FAMILY PRACTICE	272 CHRISTY STREET	AMHERST	WI	Terminated
SCH520019-17	Child	SCH	ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. - DBA ASPIRUS RHINELANDER HOSPITAL	ASPIRUS PLOVER CLINIC - VERN HOLMES DRIVE - VERN HOLMES DRIVE - FAMILY PRACTICE	5409 VERN HOLMES DRIVE	STEVENS POINT	WI	Terminated
SCH520019-18	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS WOODRUFF CLINIC - MAPLE STR - OB	240 MAPLE ST	WOODRUFF	WI	Terminated
SCH520019-19	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS WOODRUFF CLINIC - MAPLE STR - PODIATRY	240 MAPLE ST	WOODRUFF	WI	Terminated
SCH520019-21	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS PLOVER CLINIC - PLOVER ROAD - WALK IN	2401 PLOVER RD	PLOVER	WI	Terminated
SCH520019-22	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - ALLERGY	824 ILLINOIS VE	STEVENS POINT	WI	Terminated
SCH520019-23	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - SURGERY - GENERAL SURGERY	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-24	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - NEUROLOGY	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-25	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - DERMATOLOGY	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-26	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - DIABETIC	824 ILLINOIS VE	STEVENS POINT	WI	Terminated
SCH520019-27	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - ENT	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-28	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - UROLOGY	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-29	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - OB	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-30	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - WOUND	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-31	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - GI	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-32	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - OPHTHAMOLOGY	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated
SCH520019-33	Child	SCH	ASPIRUS RHINELANDER HOSPITAL	ASPIRUS STEVENS POINT CLINIC - ILLINOIS AVE - PODIATRY	824 ILLINOIS AVE	STEVENS POINT	WI	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2025 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		4/1/2025 12:00:00 AM	2/12/2025 9:34 AM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	2/12/2025 9:34 AM
Terminations	Termination Date	Update	Hospital Type Change Request		4/1/2025 12:00:00 AM	2/12/2025 9:34 AM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		4/1/2025 12:00:00 AM	2/12/2025 9:34 AM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	2/12/2025 9:34 AM
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	1/6/2025 10:53 AM
Details	State	Update		Approved	Active	10/1/2024 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Reinstatement	10/1/2023 12:00:00 AM		8/29/2024 9:54 AM
Details	Entity Name	Update	Reinstatement	ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. - DBA ASPIRUS RHINELANDER HOSPITAL	ASPIRUS RHINELANDER HOSPITAL	8/29/2024 9:54 AM
Dates	Participating Approval Date	Update	Reinstatement	2/16/2023 10:37:00 AM	8/29/2024 9:54:04 AM	8/29/2024 9:54 AM
Details	State	Update	Reinstatement	Terminated	Approved	8/29/2024 9:54 AM
Dates	Registration Date	Update	Reinstatement	1/6/2023 12:57:41 PM	8/22/2024 3:22:50 PM	8/29/2024 9:54 AM
Dates	Signed By Date	Update	Reinstatement	1/11/2023 7:39:01 PM	8/27/2024 8:17:14 AM	8/29/2024 9:54 AM
Dates	Start Date	Update	Reinstatement	4/1/2023 12:00:00 AM	10/1/2024 12:00:00 AM	8/29/2024 9:54 AM
Terminations	Termination Date	Update	Reinstatement	10/1/2023 12:00:00 AM		8/29/2024 9:54 AM
Terminations	Termination Effective Date	Update	Reinstatement	10/1/2023 12:00:00 AM		8/29/2024 9:54 AM
Terminations	Termination Reason	Update	Reinstatement	Change of covered entity type		8/29/2024 9:54 AM
Details	Comments Public	Insert	Reinstatement		Participated starting 4/1/2023; Terminated 10/1/2023; Reinstated 10/1/2024.	8/28/2024 4:00 PM
Details	State	Update		To Be Terminated	Terminated	10/1/2023 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		10/1/2023 12:00:00 AM	7/5/2023 3:29 PM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	7/5/2023 3:29 PM
Terminations	Termination Date	Update	Hospital Type Change Request		10/1/2023 12:00:00 AM	7/5/2023 3:29 PM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		10/1/2023 12:00:00 AM	7/5/2023 3:29 PM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	7/5/2023 3:29 PM
Dates	Last Date That 340B Drugs Purchased	Update	OPA Cancel Termination Request	7/1/2023 12:00:00 AM		6/12/2023 3:04 PM
Details	State	Update	OPA Cancel Termination Request	To Be Terminated	Active	6/12/2023 3:04 PM
Terminations	Termination Date	Update	OPA Cancel Termination Request	7/1/2023 12:00:00 AM		6/12/2023 3:04 PM
Terminations	Termination Effective Date	Update	OPA Cancel Termination Request	7/1/2023 12:00:00 AM		6/12/2023 3:04 PM
Terminations	Termination Reason	Update	OPA Cancel Termination Request	Change of covered entity type		6/12/2023 3:04 PM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		7/1/2023 12:00:00 AM	5/31/2023 1:43 PM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	5/31/2023 1:43 PM
Terminations	Termination Date	Update	Hospital Type Change Request		7/1/2023 12:00:00 AM	5/31/2023 1:43 PM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		7/1/2023 12:00:00 AM	5/31/2023 1:43 PM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	5/31/2023 1:43 PM
Details	State	Update		Approved	Active	4/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		TINCHER, PAT Vice President-Finance, Regional Markets Aspirus, Inc 7158472425	2/16/2023 10:37 AM
Details	340B ID	Update	New Registration		SCH520019-07	2/16/2023 10:37 AM
Details	Entity Name	Update	New Registration	ASCENSION SAINT MARYS HOSPITAL	ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. - DBA ASPIRUS RHINELANDER HOSPITAL	2/16/2023 10:37 AM
Details	Entity Subname	Update	New Registration	ASPIRUS CRANDON CLINIC	ASPIRUS CRANDON CLINIC - CRANDON FAMILY PRACTICE	2/16/2023 10:37 AM
Dates	Participating Approval Date	Update	New Registration		2/16/2023 10:37:00 AM	2/16/2023 10:37 AM
Details	State	Update	New Registration	Pending	Approved	2/16/2023 10:37 AM
Dates	Signed By Date	Update	New Registration		1/11/2023 7:39:01 PM	2/16/2023 10:37 AM
Dates	Start Date	Update	New Registration		4/1/2023 12:00:00 AM	2/16/2023 10:37 AM
Addresses	Main Address	Insert	New Registration		400 W GLEN STREET CRANDON, WI 54520	1/6/2023 12:57 PM
Contacts	Authorizing Official	Insert	New Registration		TINCHER, PAT Vice President-Finance, Regional Markets Aspirus, Inc 7158472425	1/6/2023 12:57 PM
Contacts	Primary Contact	Insert	New Registration		Kolz, Stacy 340B Pharmacy Program Supervisor Aspirus, Inc. 7156104236	1/6/2023 12:57 PM
Details	Assistance Received From Date	Insert	New Registration			1/6/2023 12:57 PM
Details	Assistance Received To Date	Insert	New Registration			1/6/2023 12:57 PM
Details	Last Recertification Date	Insert	New Registration			1/6/2023 12:57 PM
Details	Grant Number	Insert	New Registration			1/6/2023 12:57 PM
Details	340B ID	Insert	New Registration			1/6/2023 12:57 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/6/2023 12:57 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/6/2023 12:57 PM
Details	Medicare Provider Number	Insert	New Registration		520019	1/6/2023 12:57 PM
Details	Entity Name	Insert	New Registration		ASCENSION SAINT MARYS HOSPITAL	1/6/2023 12:57 PM
Details	NOFO Number	Insert	New Registration			1/6/2023 12:57 PM
Details	Program Code	Insert	New Registration		SCH	1/6/2023 12:57 PM
Details	Entity Subname	Insert	New Registration		ASPIRUS CRANDON CLINIC	1/6/2023 12:57 PM
Dates	Participating Approval Date	Insert	New Registration			1/6/2023 12:57 PM
Details	State	Insert	New Registration		Pending	1/6/2023 12:57 PM
Dates	Registration Date	Insert	New Registration		1/6/2023 12:57:41 PM	1/6/2023 12:57 PM
Dates	Signed By Date	Insert	New Registration			1/6/2023 12:57 PM
Dates	Start Date	Insert	New Registration			1/6/2023 12:57 PM
Terminations	Termination Comments	Insert	New Registration			1/6/2023 12:57 PM
Terminations	Termination Date	Insert	New Registration			1/6/2023 12:57 PM
Terminations	Termination Effective Date	Insert	New Registration			1/6/2023 12:57 PM
Terminations	Termination Reason	Insert	New Registration			1/6/2023 12:57 PM