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DSH240088 RICE MEMORIAL HOSPITAL (Active)
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Main Details
Name
RICE MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH240088
Medicare Provider Number
240088
Additional Details
Current Program Status
Active
Registration Date
6/25/2018
Participating Start Date
6/25/2018
Participating Approval Date
6/25/2018
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
CentraCare Paynesville
Craig Henneman, President
(320) 243-3767 Ext: 42177
Primary Contact
CentraCare Health Paynesville
TODD LEMKE, PHARMACIST
(320) 243-7772
Addresses
Street Address
301 BECKER AVE. SW
WILLMAR, MN 56201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2010, terminated 7/1/2011. Reinstated 6/25/2018.
06/25/2018
April 2025
April 2025
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