340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH520087A Gundersen Lutheran Medical Center, Inc. (Active)
Print
Main Details
Name
Gundersen Lutheran Medical Center, Inc.
Subdivision Name
Hemodialysis - Prairie du Chien
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH520087A
Medicare Provider Number
520087
Outpatient Facility Provider Number
523500
Additional Details
Current Program Status
Active
Registration Date
1/12/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/21/2018
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Gundersen Health system
Michelle Micka, VP Finance
(608) 775-3131 Ext: 53131
Primary Contact
Gundersen Health System
Loren Carrell, Director
(608) 775-6369
Addresses
Street Address
610 E. Taylor Street
Prairie du Chien, WI 53821
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Started participation 7/1/2012; Terminated on 7/1/2017; Reinstated on 4/1/2012.
02/20/2018
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session