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SCH520109-00 MILE BLUFF MEDICAL CENTER INC. (Active)
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Main Details
Name
MILE BLUFF MEDICAL CENTER INC.
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH520109-00
Medicare Provider Number
520109
Additional Details
Current Program Status
Active
Registration Date
10/2/2013
Participating Start Date
1/1/2016
Participating Approval Date
10/25/2013
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Mile Bluff Medical Center
Dara Beth Bartels, Chief Executive Officer
(608) 847-2992
Primary Contact
Mile Bluff Medical Center
Craig William Griffis, Director of Pharmacy
(608) 847-1255
Addresses
Street Address
1050 DIVISION STREET
Mauston, WI 53948
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/23/15 participating 1/1/14 until terminated 10/1/15, reinstated effective 1/1/16
11/23/2015
May 2025
May 2025
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