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SCH240075-02 ST JOSEPHS MEDICAL CENTER (Active)
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Main Details
Name
ST JOSEPHS MEDICAL CENTER
Subdivision Name
Essentia Health St. Joseph's - Brainerd Clinic / Cardiology
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH240075-02
Medicare Provider Number
240075
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/29/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/30/2024
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
Essentia Health
Bradley Beard, Chief Operating Officer
(218) 786-2652
Primary Contact
Essentia Health
Nick Sharrow, Pharmacy Business Services Director
(218) 606-9246
Addresses
Street Address
2024 South Sixth Street
Brainerd, MN 56401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (04/01/2025) until terminated effective date: (01/01/2016); reinstatement effective date: (07/1/2024)
04/30/2024
May 2025
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