340B Drug Pricing Program Database
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DSH240057Q ABBOTT NORTHWESTERN HOSPITAL (Active)
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Main Details
Name
ABBOTT NORTHWESTERN HOSPITAL
Subdivision Name
Abbott Northwestern WestHealth Imaging
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240057Q
Medicare Provider Number
240057
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/23/2015
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Allina Health
Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785
Primary Contact
Allina Health
Jeremy Enger, 340B Program Manager
(612) 760-7836
Addresses
Street Address
2855 Campus Drive
Plymouth, MN 55441
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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