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CAH241355-00 GLENCOE REGIONAL HEALTH SERVICES (Active)
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Main Details
Name
GLENCOE REGIONAL HEALTH SERVICES
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH241355-00
Medicare Provider Number
241355
Additional Details
Current Program Status
Active
Registration Date
2/25/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/4/2011
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Glencoe Regional Health Services
Angela Erickson, Chief Financial Officer
(320) 864-7797
Primary Contact
Glencoe Regional Health Services
AMY DITTMER, PHARMACY DIRECTOR
(320) 864-7825
Addresses
Street Address
1805 HENNEPIN AVENUE NORTH
GLENCOE, MN 55336
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/22/11 - Deleted NPI# (was 1508885633)
12/22/2011
April 2025
April 2025
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