340B Drug Pricing Program Database
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CAH521350-00 LANGLADE HOSPITAL - HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN; DBA ASPIRUS LANGLADE HOSPITAL (Active)
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Main Details
Name
LANGLADE HOSPITAL - HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN; DBA ASPIRUS LANGLADE HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521350-00
Medicare Provider Number
521350
Additional Details
Current Program Status
Active
Registration Date
1/14/2011
Participating Start Date
4/1/2011
Participating Approval Date
1/14/2011
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Aspirus, Inc.
Jerry Yang, SVP & Chief Financial Officer, Fiscal Services
(715) 847-2526
Primary Contact
Aspirus, Inc.
Stacy Kolz, 340B Pharmacy Program Supervisor
(715) 610-4236
Addresses
Street Address
112 E. 5TH AVENUE
ANTIGO, WI 54409
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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