340B Drug Pricing Program Database
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DSH240038L United Hospital (Active)
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Main Details
Name
United Hospital
Subdivision Name
United Pain Management Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240038L
Medicare Provider Number
240038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/30/2012
Participating Start Date
10/1/2013
Participating Approval Date
9/15/2013
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Allina Health
Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785
Primary Contact
Allina Health
Jeremy Enger, 340B Program Manager
(612) 760-7836
Addresses
Street Address
255 North Smith Avenue
100
St Paul, MN 55102-2518
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/15/13 Enrolled 10/1/2012 and terminated 7/1/2013 due to a reported DSH percentage below the statutory minimum. Ineligible from 7/1/2013 through 9/30/2013; reinstated effective 10/1/2013.
09/15/2013
April 2025
April 2025
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