340B Drug Pricing Program Database
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DSH240006H OLMSTED MEDICAL CENTER (Terminated)
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Main Details
Name
OLMSTED MEDICAL CENTER
Subdivision Name
OMC NORTHWEST OFFICE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240006H
Medicare Provider Number
240006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/14/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/15/2010
Last Recertification Date
8/31/2020
Termination Date
Termination Reason
1/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Olmsted Medical Center
Kevin Higgins, Chief Financial Officer
(507) 529-6619
Primary Contact
Olmsted Medical Center Hospital Pharmacy
Jennifer King, 340B Program Coordinator
(507) 529-6870
Addresses
Street Address
5067 55TH ST NW
ROCHESTER, MN 55901
Billing Address
Olmsted Medical Center
1650 4th St SE
Rochester, MN 55904
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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