340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH240001N North Memorial Health Care (Active)
Print
Main Details
Name
North Memorial Health Care
Subdivision Name
NORTH MEMORIAL RHEUMATOLOGYBLAINE - Rheumatology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240001N
Medicare Provider Number
240001
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
Maple Grove Hospital
Trevor Sawallish, CEO
(763) 581-4721
Primary Contact
North Memorial Health
Barbara Hintzen, Pharmacy Program Manager
(763) 581-2099
Addresses
Street Address
4181 108TH AVE NE
STE 200
BLAINE, MN 55449-7439
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session