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CAH241370-03 ST. GABRIEL'S HOSPITAL (Active)
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Main Details
Name
ST. GABRIEL'S HOSPITAL
Subdivision Name
RANDALL LAKES AREA CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241370-03
Medicare Provider Number
241370
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/15/2012
Participating Start Date
10/1/2012
Participating Approval Date
8/29/2012
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
St Gabriel's Hospital
STEVEN SMITH, President
(320) 631-5600
Primary Contact
CommonSpirit Health - Central Region
Mitchell Schultz, RPh, 340b Regional Manager
(701) 928-0620
Addresses
Street Address
250 WHITE OAK DRIVE
RANDALL, MN 56475
Billing Address
St. Gabriel's Hospital
815 2nd St.S. E.
Little Falls, MN 56345
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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