Covered Entity Details

RRC520030-08 ASPIRUS WAUSAU HOSPITAL (Active) - information as of 4/25/2025 6:34:34 PM

Main Details

Name

ASPIRUS WAUSAU HOSPITAL

Subdivision Name

ASPIRUS INFECTIOUS DISEASE - INFECTIOUS DISEASE CLINIC

Type

Rural Referral Center

Rural

Yes

340B ID

RRC520030-08

Medicare Provider Number

520030

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/12/2023

Participating Start Date

2/23/2023

Participating Approval Date

2/16/2023

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

2720 PLAZA DR
STE 1400
WAUSAU, WI 54401-4166

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
RRC520030-01	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS WAUSAU HOSPITAL INC - ASPIRUS MARATHON CLINIC	670 COMMUNITY CIRCLE	MARATHON	WI	Active
RRC520030-02	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS WAUSAU HOSPITAL INC - ASPIRUS PULMONARY & CRITICAL CARE	425 PINE RIDGE BLVD	WAUSAU	WI	Active
RRC520030-03	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS WAUSAU HOSPITAL INC - ASPIRUS WAUSAU HOSPITAL - WOUND CLINIC	333 PINE RIDGE BLVD	WAUSAU	WI	Active
RRC520030-04	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS WAUSAU HOSPITAL INC - ASPIRUS MERRILL CLINIC	3333 EAST MAIN ST	MERRILL	WI	Active
RRC520030-05	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS WAUSAU HOSPITAL - ASPIRUS CANCER CARE - WAUSAU	215 N 28TH AVE	WAUSAU	WI	Active
RRC520030-06	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS WAUSAU HOSPITAL KIDNEY CARE - ASPIRUS NEPHROLOGY CLINIC	3000 WESTHILL DRIVE	WAUSAU	WI	Active
RRC520030-07	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS WAUSAU HOSPITAL INC - ASPIRUS DERMATOLOGY CLINIC	1901 Westwood Center Boulevard	WAUSAU	WI	Active
RRC520030-08	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS INFECTIOUS DISEASE - INFECTIOUS DISEASE CLINIC	2720 PLAZA DR	WAUSAU	WI	Active
RRC520030-09	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS RHEUMATOLOGY CLINIC - RHEUMATOLOGY	2720 PLAZA DRIVE	WAUSAU	WI	Active
RRC520030-10	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS FAMILY HEALTH SPECIALISTS - FAMILY PRACTICE	2720 PLAZA DRIVE	WAUSAU	WI	Active
RRC520030-11	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS REGIONAL CANCER CENTER - RADIATION ONCOLOGY	215 N 28TH AVE	WAUSAU	WI	Active
RRC520030-12	Child	RRC	ASPIRUS WAUSAU HOSPITAL	ASPIRUS FAMILY WALK-IN - WALK-IN CLINIC	2720 PLAZA DRIVE	WAUSAU	WI	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	1/6/2025 10:53 AM
Details	Last Recertification Date	Update	Recertification	8/24/2023 8:13:33 AM	8/22/2024 7:44:08 PM	8/22/2024 7:44 PM
Details	Last Recertification Date	Update	Recertification		8/24/2023 8:13:33 AM	8/24/2023 8:13 AM
Details	State	Update	OPA Edit	Approved	Active	2/23/2023 9:51 AM
Dates	Start Date	Update	OPA Edit	4/1/2023 12:00:00 AM	2/23/2023 12:00:00 AM	2/23/2023 9:51 AM
Contacts	Signed By	Insert	New Registration		TINCHER, PAT Vice President-Finance, Regional Markets Aspirus, Inc 7158472425	2/16/2023 12:14 PM
Details	340B ID	Update	New Registration		RRC520030-08	2/16/2023 12:14 PM
Details	Entity Subname	Update	New Registration	ASPIRUS INFECTIOUS DISEASE	ASPIRUS INFECTIOUS DISEASE - INFECTIOUS DISEASE CLINIC	2/16/2023 12:14 PM
Dates	Participating Approval Date	Update	New Registration		2/16/2023 12:14:45 PM	2/16/2023 12:14 PM
Details	State	Update	New Registration	Pending	Approved	2/16/2023 12:14 PM
Dates	Signed By Date	Update	New Registration		2/14/2023 6:07:57 PM	2/16/2023 12:14 PM
Dates	Start Date	Update	New Registration		4/1/2023 12:00:00 AM	2/16/2023 12:14 PM
Addresses	Main Address	Insert	New Registration		2720 PLAZA DR STE 1400 WAUSAU, WI 54401-4166	1/12/2023 5:19 PM
Contacts	Authorizing Official	Insert	New Registration		TINCHER, PAT Vice President-Finance, Regional Markets Aspirus, Inc 7158472425	1/12/2023 5:19 PM
Contacts	Primary Contact	Insert	New Registration		Kolz, Stacy 340B Pharmacy Program Supervisor Aspirus, Inc. 7156104236	1/12/2023 5:19 PM
Details	Assistance Received From Date	Insert	New Registration			1/12/2023 5:19 PM
Details	Assistance Received To Date	Insert	New Registration			1/12/2023 5:19 PM
Details	Last Recertification Date	Insert	New Registration			1/12/2023 5:19 PM
Details	Grant Number	Insert	New Registration			1/12/2023 5:19 PM
Details	340B ID	Insert	New Registration			1/12/2023 5:19 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/12/2023 5:19 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/12/2023 5:19 PM
Details	Medicare Provider Number	Insert	New Registration		520030	1/12/2023 5:19 PM
Details	Entity Name	Insert	New Registration		ASPIRUS WAUSAU HOSPITAL	1/12/2023 5:19 PM
Details	NOFO Number	Insert	New Registration			1/12/2023 5:19 PM
Details	Program Code	Insert	New Registration		RRC	1/12/2023 5:19 PM
Details	Entity Subname	Insert	New Registration		ASPIRUS INFECTIOUS DISEASE	1/12/2023 5:19 PM
Dates	Participating Approval Date	Insert	New Registration			1/12/2023 5:19 PM
Details	State	Insert	New Registration		Pending	1/12/2023 5:19 PM
Dates	Registration Date	Insert	New Registration		1/12/2023 5:19:39 PM	1/12/2023 5:19 PM
Dates	Signed By Date	Insert	New Registration			1/12/2023 5:19 PM
Dates	Start Date	Insert	New Registration			1/12/2023 5:19 PM
Terminations	Termination Comments	Insert	New Registration			1/12/2023 5:19 PM
Terminations	Termination Date	Insert	New Registration			1/12/2023 5:19 PM
Terminations	Termination Effective Date	Insert	New Registration			1/12/2023 5:19 PM
Terminations	Termination Reason	Insert	New Registration			1/12/2023 5:19 PM