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DSH240047 St. Luke's Hospital of Duluth (Active)
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Main Details
Name
St. Luke's Hospital of Duluth
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH240047
Medicare Provider Number
240047
Additional Details
Current Program Status
Active
Registration Date
7/15/2013
Participating Start Date
10/1/2013
Participating Approval Date
8/19/2013
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
St. Luke's Hospital of Duluth
Michael Boeselager, Vice President Support Services
(218) 249-2459
Primary Contact
Aspirus, Inc.
Stacy Kolz, 340B Pharmacy Program Supervisor
(715) 610-4236
Addresses
Street Address
915 East First Street
Duluth, MN 55805
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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