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CAH241356-00 MILLE LACS HOSPITAL (Active)
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Main Details
Name
MILLE LACS HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241356-00
Medicare Provider Number
241356
Additional Details
Current Program Status
Active
Registration Date
1/6/2015
Participating Start Date
4/1/2015
Participating Approval Date
2/10/2015
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Mille Lacs Health System
Bill Nelson, CEO
(320) 532-2580
Primary Contact
Mille Lacs Health System
Jennifer McDonnell, Pharmacy Manager
(320) 532-2490
Addresses
Street Address
200 N Elm St
ONAMIA, MN 56359
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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