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CAH241326-00 CENTRACARE HEALTH SYSTEM-LONG PRAIRIE (Active)
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Main Details
Name
CENTRACARE HEALTH SYSTEM-LONG PRAIRIE
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241326-00
Medicare Provider Number
241326
Additional Details
Current Program Status
Active
Registration Date
9/24/2010
Participating Start Date
9/29/2010
Participating Approval Date
9/24/2010
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
CentraCare Health
Jose Alba, President
(320) 732-7210
Primary Contact
CentraCare Health
CHRISTOPHER HAGEN, PHARMACY MANAGER
(320) 732-7247
Addresses
Street Address
50 CentraCare Drive
LONG PRAIRIE, MN 56347
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/18/2010 REMOVE NPI#(WAS1164471678)
11/18/2010
May 2025
May 2025
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