340B Drug Pricing Program Database
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CAH241301-00 LAKEWOOD HEALTH CENTER (Active)
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Main Details
Name
LAKEWOOD HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241301-00
Medicare Provider Number
241301
Additional Details
Current Program Status
Active
Registration Date
1/11/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/15/2019
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
CHI LakeWood Baudette
Jeffry Alan Stampohar, VP
(218) 634-3401
Primary Contact
CommonSpirit Health - Central Region
Mitchell Schultz, RPh, 340b Regional Manager
(701) 928-0620
Addresses
Street Address
600 MAIN AVENUE S
BAUDETTE, MN 56623
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 9/28/2010; terminated 1/1/2018; Reinstated 4/1/2019.
01/14/2019
Participated starting 9/28/2010; terminated 1/1/2018; Reinstated 4/1/2018.
01/14/2019
7/15/11 removed NPI#s
07/15/2011
May 2025
May 2025
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