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SCH240075-83 ST JOSEPHS MEDICAL CENTER (Active)
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Main Details
Name
ST JOSEPHS MEDICAL CENTER
Subdivision Name
Essentia Health St Josephs Deerwood Clinic / - Family Practice - DRWD
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH240075-83
Medicare Provider Number
240075
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/30/2024
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
24087 CUYUNA ST
DEERWOOD, MN 56444
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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