340B Drug Pricing Program Database
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DSH240001 North Memorial Health Care (Active)
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Main Details
Name
North Memorial Health Care
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240001
Medicare Provider Number
240001
Additional Details
Current Program Status
Active
Registration Date
10/12/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/26/2012
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Maple Grove Hospital
Trevor Sawallish, CEO
(763) 581-4721
Primary Contact
North Memorial Health
Barbara Hintzen, Pharmacy Program Supervisor
(763) 581-2099
Addresses
Street Address
3300 Oakdale Ave North
Robbinsdale, MN 55422
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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