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CAH241349-00 CENTRACARE HEALTH - PAYNESVILLE (Active)
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Main Details
Name
CENTRACARE HEALTH - PAYNESVILLE
Subdivision Name
CENTRACARE HEALTH - PAYNESVILLE HOSPITAL
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241349-00
Medicare Provider Number
241349
Additional Details
Current Program Status
Active
Registration Date
2/21/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/2/2011
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
CentraCare Melrose
Jennifer Tschida, President
(320) 256-1822 Ext: 24151
Primary Contact
CentraCare Health Paynesville
TODD LEMKE, PHARMACIST
(320) 243-7772
Addresses
Street Address
200 FIRST ST W
PAYNESVILLE, MN 56362
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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