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CAH241373-00 PERHAM HOSPITAL DISTRICT DBA PERHAM HEALTH (Active)
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Main Details
Name
PERHAM HOSPITAL DISTRICT DBA PERHAM HEALTH
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241373-00
Medicare Provider Number
241373
Additional Details
Current Program Status
Active
Registration Date
11/15/2010
Participating Start Date
1/1/2011
Participating Approval Date
11/15/2010
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Perham Health
CHARLES A. HOFIUS, CEO
(218) 347-1301
Primary Contact
PERHAM HOSPITAL DISTRICT DBA PERHAM HEALTH
ERIC JOHN BRANDVOLD, PHARMACIST
(218) 347-1572
Addresses
Street Address
1000 Coney Street West
PERHAM, MN 56573
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/24/12 - Updated addr (was 665 3RD STREET SW);Updated entity name(was PERHAM HOSPITAL DISTRICT DBA PERHAM MEMORIAL HOSPITAL AND HOME)
02/24/2012
April 2025
April 2025
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