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DSH240106Y REGIONS HOSPITAL (Active)
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Main Details
Name
REGIONS HOSPITAL
Subdivision Name
REGIONS HOSPITAL - Cancer Clinic - Coon Rapids
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240106Y
Medicare Provider Number
240106
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/2/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/8/2024
Last Recertification Date
Contacts
Authorizing Official
Regions Hospital
John M Clark, VP Finance
(651) 254-0900
Primary Contact
Regions Hospital
Tanya Y Barnhart, Director, Pharmaceutical Services
(651) 254-9560
Addresses
Street Address
11850 BLACKFOOT ST NW
STE 200
COON RAPIDS, MN 55433-2593
Billing Address
Regions Hospital
640 Jackson St
St Paul, MN 55101
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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