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CAH521340-02 Mayo Clinic Health System - Red Cedar (Terminated)
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Main Details
Name
Mayo Clinic Health System - Red Cedar
Subdivision Name
MCHS- Red Cedar in Elmwood- Family Medicine
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521340-02
Medicare Provider Number
521340
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2013
Participating Start Date
4/1/2013
Participating Approval Date
1/14/2013
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
Mayo Clinic
Michele Eberle, Vice Chair-Administration NWWI
(715) 568-6113
Primary Contact
Mayo Clinic
Alicia Buda, Operations Manager
(507) 293-3251
Addresses
Street Address
236 East Springer Avenue
Elmwood, WI 54740
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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