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CAH241362-04 CENTRACARE HEALTH-MONTICELLO (Active)
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Main Details
Name
CENTRACARE HEALTH-MONTICELLO
Subdivision Name
HVC Vascular Surgery Clinic - Vascular Surgery Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241362-04
Medicare Provider Number
241362
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/9/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/31/2024
Last Recertification Date
Contacts
Authorizing Official
CentraCare Health - Monticello
John Roland Hering, President
(763) 271-2445
Primary Contact
CentraCare Health-Monticello
Natalie Adams, Pharmacy Director
(763) 271-2425
Addresses
Street Address
1001 Hart BLVD
Suite150
Monticello, MN 55362
Billing Address
CentraCare Monticello
1013 Hart Blvd
Monticello, MN 55362
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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