340B Drug Pricing Program Database
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DSH240071 Allina Health Faribault Medical Center (Active)
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Main Details
Name
Allina Health Faribault Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH240071
Medicare Provider Number
240071
Additional Details
Current Program Status
Active
Registration Date
10/2/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/26/2015
Last Recertification Date
8/16/2024
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
200 STATE AVENUE
FARIBAULT, MN 55021
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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