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DSH240106M REGIONS HOSPITAL (Terminated)
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Main Details
Name
REGIONS HOSPITAL
Subdivision Name
ADAP (ALCOHOL DRUG ABUSE PROGRAM)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240106M
Medicare Provider Number
240106
Outpatient Facility Provider Number
240106
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/3/2014
Last Recertification Date
8/25/2020
Termination Date
Termination Reason
4/1/2021
Site closure
Contacts
Authorizing Official
Regions Hospital
HEIDI CONRAD, CFO
(651) 254-0900
Primary Contact
Regions Hospital
Tanya Y Barnhart, Director, Pharmaceutical Services
(651) 254-9560
Addresses
Street Address
445 ETNA STREET
SUITE 55
ST PAUL, MN 55106-5848
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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