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CAH521304-00 St. Joseph's Health Services, Inc. dba St. Joseph's Health Services-Gundersen Lutheran (Active)
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Main Details
Name
St. Joseph's Health Services, Inc. dba St. Joseph's Health Services-Gundersen Lutheran
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521304-00
Medicare Provider Number
521304
Additional Details
Current Program Status
Active
Registration Date
2/28/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/16/2011
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Memorial Hospital of Boscobel
Jennifer Boigenzahn, Finance Administrator
(608) 375-6228
Primary Contact
STJ
Scott Larson, Director of Pharmacy
(608) 489-8225
Addresses
Street Address
400 WATER AVE
HILLSBORO, WI 54634
Billing Address
ST. JOSEPH'S HEALTH SERVICES, INC.
PO BOX 527
HILLSBORO, WI 54634-0527
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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