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HM6968 MAYO CLINIC ROCHESTER (Active)
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Main Details
Name
MAYO CLINIC ROCHESTER
Subdivision Name
Mayo Clinic Hemophilia Treatment Center
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM6968
Grant Number
H30MC24052
Additional Details
Current Program Status
Active
Registration Date
11/29/2006
Participating Start Date
1/1/2007
Participating Approval Date
11/29/2006
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
MAYO CLINIC
RAJIV K. PRUTHI, DIRECTOR
(507) 284-2511
Primary Contact
Mayo Clinic -Rochester
Matthew A. Hathcock, Program manager
(507) 293-2091
Addresses
Street Address
200 FIRST STREET SW
ROCHESTER, MN 55905
Billing Address
ATTN: DR RAJIV K. PRUTHI
200 First Street, SW
Hilton 200-1
ROCHESTER, MN 55905
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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10/7/08 REMOVED MEDICAID # (WAS 06232700);10/7/08 ADDED MEDICAID #; 9/6/07 UPDATED BILL TO (WAS HILTON 1, 200 FIRST STREET SW);
11/29/2006
April 2025
April 2025
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