340B Drug Pricing Program Database
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CAH521355-00 ThedaCare Medical Center Berlin, Inc. (Active)
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Main Details
Name
ThedaCare Medical Center Berlin, Inc.
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521355-00
Medicare Provider Number
521355
Additional Details
Current Program Status
Active
Registration Date
4/12/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/9/2011
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
ThedaCare Medical Center Berlin
Tammy Bending, Vice President, Critical Access Hositals
(920) 361-5585
Primary Contact
ThedaCare
Angela M Baltz, 340B Compliance Analyst - ACE
(920) 579-1393
Addresses
Street Address
225 MEMORIAL DRIVE
BERLIN, WI 54923
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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