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SCH240075-26 ST JOSEPHS MEDICAL CENTER (Active)
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Main Details
Name
ST JOSEPHS MEDICAL CENTER
Subdivision Name
Essentia Health St. Joseph's - Baxter Clinic / General Pediatrics
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH240075-26
Medicare Provider Number
240075
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
2/23/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/27/2018
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
13060 ISLE DR
BAXTER, MN 56425
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2015, terminated 1/1/2016. Reinstated 4/1/2018.
02/27/2018
May 2025
May 2025
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