340B Drug Pricing Program Database
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DSH240019FL SMDC MEDICAL CENTER (Active)
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Main Details
Name
SMDC MEDICAL CENTER
Subdivision Name
Essentia Health Duluth Clinic Building E / - Psychiatry
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240019FL
Medicare Provider Number
240019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/7/2024
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
Essentia Health
Bradley Beard, Chief Operating Officer
(218) 786-2652
Primary Contact
Essentia Health
Nick Sharrow, Pharmacy Business Services Director
(218) 606-9246
Addresses
Street Address
530 EAST 2ND STREET
DULUTH, MN 55805
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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