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CAH241367-01 Welia Health (Active)
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Main Details
Name
Welia Health
Subdivision Name
Welia Health - Mora Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241367-01
Medicare Provider Number
241367
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/31/2012
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Welia Health
Randy William Ulseth, CEO
(320) 225-3315
Primary Contact
Welia Health
Joe Dvorak, Director of Pharmacy
(320) 225-3592
Addresses
Street Address
301 Highway 65 S
Mora, MN 55051
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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