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DSH240101 ST MARYS REGIONAL HEALTH CENTER (Active)
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Main Details
Name
ST MARYS REGIONAL HEALTH CENTER
Subdivision Name
Essentia Health St. Mary's
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH240101
Medicare Provider Number
240101
Additional Details
Current Program Status
Active
Registration Date
12/10/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/11/2014
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Essentia Health
Tanner Goodrich, Senior Vice President of Operations
(218) 847-0851
Primary Contact
Essentia Health
Nick Sharrow, Pharmacy Business Services Director
(218) 606-9246
Addresses
Street Address
1027 WASHINGTON AVE
DETROIT LAKES, MN 56501
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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