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DSH240069 OWATONNA HOSPITAL (Terminated)
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Main Details
Name
OWATONNA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH240069
Medicare Provider Number
240069
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/4/2020
Last Recertification Date
9/6/2022
Termination Date
Termination Reason
7/1/2023
DSH percentage below statutory minimum
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
2250 NW 26TH STREET
OWATONNA, MN 55060
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (10/1/2013), until terminated effective date: (7/1/2017), reinstatement effective date: (01/01/2021)
11/03/2020
9/15/13 Enrolled 1/1/2013 and terminated 7/1/2013 at entity request. 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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